Girls at risk:
Research shows an unparalleled rise in adolescent
girls using prescription drugs to treat diabetes, sleep problems and
psychological disorders
Increases in medication use
among 10 to 19 year-old girls for several
chronic and behavioral conditions far outpaces boys of the same age
ALLIANCE FOR HUMAN RESEARCH
PROTECTION (AHRP)
Promoting Openness, Full Disclosure, and Accountability
www.ahrp.org and http://ahrp.blogspot.com
FYI
The most recent report by MEDCO Health Solutions, the nation's leading
pharmacy benefit manager, analyzing use of psychotropic drugs in children is
so disturbing that the company's chief medical officer, Dr. Robert Epstein,
expressed concern about the "unparalleled rise in adolescent girls using
prescription drugs to teat diabetes, sleep problems, and psychological
disorders."
"While drug therapy is essential for certain patients, the risks and
benefits must always be weighed and, when clinically appropriate, non-drug
treatments should be the initial approach."
The astronomical rise in diabetes type 2 in adolescents parallels the
atronomical increased use of the atypical antipsychotics in children.
This drug-induced epidemic will go down in history as the crime of the
centrury.
The report notes "one hopeful sign"--
"The slowing of growth in pediatric utilization of ADHD drugs,
antipsychotics, and sleep medications from 2005 to 2006 may be a reflection
of the concerns raised by reports such as the Medco research. "
Dr. Epstein attributes this to increased public awareness: "FDA Black Box
warnings and media reports about side effects over the past few years have
raised public awareness of the growing use of medications among children.
The associated risks may be impacting parents' and physicians' willingness
to put children on these drugs."
And he acknowledges, non-chemical solution is desirable: " When dealing with
the causes of sleep disorders and type 2 diabetes, in many cases, lifestyle
changes may be the first line of therapy."
Contact: Vera Hassner Sharav
212-595-8974
veracare@ahrp.org
MEDCO
http://www.medco.com/medco/corporate/home.jsp?ltSess=y&articleID=CorpAlertgirlsDiabetesdrugs
Latest News
Girls at risk: Research shows an unparalleled rise in adolescent girls using
prescription drugs to treat diabetes, sleep problems and psychological
disorders
-- Increases in medication use among 10 to 19 year-old girls for several
chronic and behavioral conditions far outpaces boys of the same age
ORLANDO, Fla., May 16, 2007 - New research suggests that adolescent girls
may be at increasing risk for several physical and psychological health
problems. The analysis by Medco Health Solutions, Inc. (NYSE: MHS) finds a
significant increase in the number of girls ages 10 to 19 taking
prescription drugs including medications to treat diabetes, sleep aids,
antipsychotics and attention deficit/hyperactivity disorder (ADHD), far
outpacing the growth seen among their male counterparts.
According to the data, the number of girls ages 10 to19 on diabetes
medications in total grew nearly 59 percent from 2001 to 2006 as compared to
boys whose use increased by only 14 percent. However, the increase in type 2
diabetes medication use has risen a dramatic 167 percent in girls ages 10 to
19 and only 33 percent in boys the same age. There are now three and half
times more girls than boys on drug therapy for type 2 diabetes, whether for
treatment of type 2 diabetes or obesity related conditions.
The research, which reviewed prescription drug claims of some 370,000 girls
and boys ages 10 to 19, also found the prevalence of adolescent girls taking
antipsychotic drugs grew 117 percent, whereas boys that age had an increase
of 71 percent. Further findings showed that 46 percent more girls than boys
took sleep medications in 2006, with girls increasing their use over the
past five years by over 80 percent. The increase in prevalence of girls
taking ADHD medications was double that of boys, showing a 74 percent jump
over the past five years, although the prevalence among boys is still
greater.
"This analysis raises concerns and questions about the health of adolescents
in America, and particularly girls," said Dr. Robert Epstein, Medco's chief
medical officer. "While this may be evidence that more girls are for the
first time being appropriately diagnosed and treated, it also raises red
flags about the physical and psychological problems afflicting this
population."
One hopeful sign from the data is that while the prevalence rates continue
to rise, there was a significant slowing of that growth from 2005 to 2006
for girls ages 10 to19. Over that year, the number of diabetes patients
increased only 3 percent as compared to 15 percent the prior year; increases
in the use of antipsychotics dropped by almost half - from 7.4 percent
between 2004 to 2005 to just under 4 percent last year; and the number of
ADHD patients grew a mere 0.3 percent from 2005 to 2006, significantly lower
than the 4 percent increase the year before. Sleep medication use, however,
grew to 12 percent from 2005 to 2006, up from 6.3 percent the prior year.
"FDA Black Box warnings and media reports about side effects over the past
few years have raised public awareness of the growing use of medications
among children. The associated risks may be impacting parents' and
physicians' willingness to put children on these drugs," said Epstein. "When
dealing with the causes of sleep disorders and type 2 diabetes, in many
cases, lifestyle changes may be the first line of therapy."
For more than five years, Medco has been bringing to the public forefront
pediatric prescription drug trends, issues and concerns, especially in the
area of behavioral medication use. The company's vigilance in this area has
contributed to a growing awareness of increased utilization of these
medications among children and has been instrumental in furthering the
discussion of the factors behind this development.
The slowing of growth in pediatric utilization of ADHD drugs,
antipsychotics, and sleep medications from 2005 to 2006 may be a reflection
of the concerns raised by reports such as the Medco research. "Medco is
dedicated to bringing this information to light to ensure pediatric patients
are receiving the most appropriate treatments for their condition," said
Epstein. "While drug therapy is essential for certain patients, the risks
and benefits must always be weighed and, when clinically appropriate,
non-drug treatments should be the initial approach."
Diabetes
While prevalence of diabetes as a whole continues to be on the rise, a
number of recent studies suggest that type 2 diabetes is increasing
dramatically. According to the New York University School of Medicine, there
has been a 200 percent jump in the number of children 18 years old and
younger hospitalized with type 2 diabetes between 1997 and 2003. The study
showed, however, that boys are 1.3 times more likely to be hospitalized than
girls, as opposed to the higher rate of girls on type 2 diabetes medication,
per Medco's analysis.
The American Obesity Association reports that approximately 30 percent of
children and adolescents between the ages of 6 and 19 are overweight, with
about 15 percent meeting the criteria for obesity. According to Pediatrics,
there are a number of reasons why adolescent girls have a greater risk of
developing type 2 diabetes. Several studies suggest that girls are more
insulin resistant than boys during puberty and adolescence. Sex-linked genes
may also have an important impact on the development of insulin resistance
and the metabolic syndrome and may help to explain the female preponderance
of type 2 diabetes in children.
For patients with type 2 diabetes, disease management through lifestyle
changes could lead to better control of blood glucose levels, as well as the
preventing or slowing the onset of diabetes-related complications. Studies
reveal that patients are most accepting of health-behavioral changes that
could improve their long-term prognosis in the first 30 days of undergoing
an event that requires treatment.
Through Optimal HealthR, a fully-integrated wellness and disease management
collaboration between Medco and Healthways, Inc., type 2 diabetes patients
are rapidly identified and proactively engaged by a staff of highly
qualified nurses who, by building a partnership with the patient and
facilitating communications with the treating physician, ensure optimum care
and outcomes, resulting in lower health plan costs for the client. Diabetes
patients also receive specialized care through a Medco Therapeutic Resource
CenterT, an advanced approach to pharmacy care that provides patients
round-the-clock access to pharmacists who are specialists in treating
diabetes patients.
Antipsychotics
Children are primarily being prescribed the latest generation of
antipsychotics - known as atypical antipsychotics, including risperidone,
olanzapine, clozapine, ziprasidone and quetiapine. These drugs have been
used as treatments for bipolar disorder, conduct disorder, ADHD, depression,
Tourette's syndrome and other conditions. Based on studies linking atypicals
with an increased risk of hyperglycemia and diabetes, the Food and Drug
Administration (FDA) requires warning labels on all these medications.
Sleep Aids
According to the National Sleep Foundation's 2006 Sleep in America poll,
only 20 percent of adolescents get the recommended nine hours of sleep on
school nights, and 45 percent sleep less than eight hours on school nights.
Also of great concern is sleep quality--one in 10 teens polled said they
rarely or never get a good night's sleep.
A 2003 study published in Pediatrics found that 75 percent of practitioners
surveyed reported recommending a non-prescription sleeping aid and 50
percent had actually prescribed one for their pediatric patients during a
six month period. In addition, the study found that the likelihood of
prescribing sleep medications was two-to-four times greater for those
physicians who treated children with ADHD.
Although drug therapy may be beneficial for short-term improvement and long
term use may be needed in some cases, the American Academy of Family
Physicians cautions that long-term use of many psychotropic or
sedative-hypnotic drugs may cause adverse reactions and may actually impair
return to normal sleep. A combination of medication and behavioral
interventions is often more effective than either approach alone for those
with chronic insomnia.
ADHD
The National Institute of Health (NIH) reports that ADHD affects nearly 2
million children in the United States. The most common behavioral disorder
in children, ADHD is generally diagnosed during the early school years.
However, approximately 75 percent of children with the condition continue to
show symptoms during adolescence. Additionally, 80 percent of children who
need medication for ADHD continue taking it in their teen years. ADHD is
typically treated with stimulants, although some children also respond well
to antidepressants.
New research out of the University of California, Berkeley found that
adolescent girls with ADHD are less prone to hyperactivity than boys, but
are more likely to exhibit other emotional and behavioral issues, including
depression and eating disorders. Additional findings show that girls have
historically been under-diagnosed with ADHD because they don't display the
impulsive and disruptive behavior often seen in boys with the condition.
About Medco
Medco Health Solutions, Inc. (NYSE:MHS) is the nation's leading pharmacy
benefit manager based on its 2006 total net revenues of more than $42
billion. Medco's prescription drug benefit programs are designed to drive
down the cost of pharmacy health care for private and public employers,
health plans, labor unions and government agencies of all sizes, and for
individuals served by the Medicare Part D Prescription Drug Program. Medco's
technologically advanced mail-order pharmacies and award-winning Internet
pharmacy have been recognized for setting new industry benchmarks for
pharmacy dispensing quality. Medco serves the needs of patients with complex
conditions requiring sophisticated treatment through its specialty pharmacy
operation, which became the nation's largest with the 2005 acquisition of
Accredo Health, Incorporated. Medco is the highest-ranked pharmacy benefit
manager on the 2006 Fortune 500 list.
On the Net: http://www.medco.com .
C 2004-2007 Medco Health Solutions, Inc. All Rights Reserved.
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