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Over 60s’ use of prescription drugs has doubled in past decade in England

BMJ 2008; 337 doi: http://dx.doi.org/10.1136/bmj.a1132 (Published 01 August 2008) Cite this as: BMJ 2008;337:a1132
  1. Andrew Cole
  1. 1London

    People in England over the age of 60 years are using twice as many prescription drugs now as they were 10 years ago, new figures released by the NHS Information Centre show.

    The statistics on prescriptions dispensed in the community show that people aged 60 or over are now given an average of 42.4 prescribed items a year, up from 22.3 in 1997. The overall number of prescriptions dispensed rose by nearly 60% over this period.

    Overall 796 million prescribed items were dispensed in England in 2007, whereas the number was 752 million in 2006 and 500 million in 1997. On average, 15.6 items are prescribed per person each year; 10 years ago the average was 10.3 items. However, the average number of items prescribed to children under 16 years fell in the same period, from 4.9 to 3.9 a year.

    More drugs are dispensed for hypertension and heart failure than for any other conditions. But the biggest increases in prescriptions from 2006 to 2007 were in dementia drugs (up by 19%), substance dependency drugs (15%), vitamins (14.7%), and oral nutrition (14%).

    Over the past 10 years the steepest rises have been in statins, which rose from less than five million prescriptions in 1997 to 45 million last year, and in hypertension and heart failure drugs, which rose from less than 15 million to more than 50 million.

    Meanwhile, the cost of prescription drugs has almost doubled since 1997, rising from £4.4bn (€5.6bn; $8.7bn) to £8.4bn last year. But there are signs that the net ingredient cost per item—that is, the cost of drugs before discounts—may be stabilising. Last year this rose by only 2.1%, which represents a 0.7% fall after inflation is taken into account.

    Although only half of the population qualifies for free prescriptions, this group now accounts for 89% of all prescriptions. Generic drugs make up 83% of all prescriptions, a small rise on the 2006 figure of 82% but up from 60% a decade ago.

    GPs are responsible for 98% of all prescribing in the community, with nurse and other non-medical prescribers accounting for 1.2%. However, prescribing by nurses rose by 50% in the past year.

    Steve Field, chairman of the Royal College of General Practitioners, said that the increase in the number of prescriptions was probably due to a combination of a rising number of elderly people, more people with chronic conditions, and greater use of drugs used in preventive treatment.

    But he warned that it was important for doctors to ensure that drugs were being taken correctly and continued to be necessary. “It’s a matter of working with patients to keep the number of items to a minimum.”

    The National Pharmacy Association said that the real concern was not that numbers of prescriptions were rising but that so many were being wasted. Research indicated that 50% of people with long term conditions did not use their drugs effectively, and this percentage increased to 75% among elderly people.

    Notes

    Cite this as: BMJ 2008;337:a1132

    Footnotes

    • Prescriptions Dispensed in the Community—Statistics for 1997-2007: England is available at www.ic.nhs.uk.