The Collison Newsletter February 2007

    

                     DRUGS – THE TOP 10 for 2005-2006 ** 

In my May 2006 Newsletter, the top 10 dugs for 2004-2005, as published in the ‘Australian Prescriber’ (February 2006), were discussed.

 

The ‘Australian Prescriber’, volume 29, number 6, December 2006, lists the top 10 drugs for 2005-2006.

 

It should be noted that these were the subsidised drugs (ie those part-paid by the Australian Government direct to the pharmaceutical companies) prescribed under the PBS (Pharmaceutical Benefits Scheme) or RPBS (Repatriation Pharmaceutical Benefits Scheme). The following tables do not include private prescriptions (ie those fully paid by the patient).

 

The Top 10 for 2005-2006 in the 3 categories (defined daily dose (DDD) / 1000 population / day, prescription counts and cost to the government) were essentially unchanged from 2004-2005. There was one deletion and one addition in table 2 (prescription counts). The deleted drug was a bronchodilator (salbutamol) and the new one was an antihypertensive agent (perindopril).

 

The 3 tables setting out the top 10 drugs in the 3 categories are set out below, listing both financial years 2004-2005 and 2005-2006, for comparison. (Refer to my May 2006 newsletter for a full description of the generic names as set out in the tables).

 

 

Table 1.   Top 10 drugs supplied by DDD/1000 pop/day

 
 
Drug 2004 - 20052005 - 2006
  

PBS/RPBS

 
  

PBS/RPBS

atorvastatin198.1731116.088
simvastatin255.967258.707
ramipril333.741335.897
diltiazem hydrochloride430.097426.970
omeprazole520.628519.531
irbesartan620.169617.971
salbutamol718.844718.073
frusemide818.775818.420
aspirin918.162918.047
sertraline1017.6041018.039
  
 Table 2.   Top 10 drugs by prescription counts 

 
Drug 2004 - 20052005 - 2006
  

PBS/RPBS

 
  

PBS/RPBS

 
atorvastatin18,074,20219,045,273
simvastatin26,275,57726,355,305
paracetamol34,772,86534,205,023
omeprazole44,411,85744,180,429
irbesartan53,370,31583,025,037
atenolol63,247,47563,259,401
salbutamol73,062,355  
esomeprazole82,983,64553,715,500
irbesartan with hydrochlorothiazide92,938,448102,962,120
ramipril102,903,04893,024,099
perindopril  73,124,409

perindopril (erbumine)

Brand Names: Perindopril (Chemmart, TerryWhtie Chemists,GenRx), Coversyl Plus

perindopril (arginine) 

Brand Name: Coversyl

ACE inhibitor. Antihypertensive agent 

 

Table 3.  Top 10 drugs by cost to Government. 

  
Drug 2004-20052005-2006
  Cost to Government ($A)   Cost to Government ($A)  Prescriptions PBS/RPBS DDD/1000/day PBS/RPBS
atorvastatin1460,930,2511522,357,6959,045,273116.088
simvastatin2369,659,0522330,247,6696,355,30558.702
omeprazole3177,075,8327149,094,7554,180,42919.531
fluticasone with salmeterol4165,690,4245165,917,5582,839,015*
clopidogrel5151,235,4664169,947,0522,179,9608.485
olanzapine6149,497,2566154,623,092745,6033.016
esomeprazole7143,233,7273169,953,7433,715,50014.265
pravastatin8119,587,71710102,445,7192,018,69513.934
alendronic acid9108,587,1838113,917,8372,297,4149.177
pantoprazole10104,291,2729103,564,5092,733,58911.603
  

(* combination drugs do not have a DDD allocated)

The total cost to the government (ie to the taxpayer) of the top 10 drugs (table 3) for 2005-2006 was A$1,982,069,629, just under 2 billion dollars. This is an increase of A$32,281,449 from the 2004-2005 cost of $1,949,788,180.

 

Again, let us look at the three 'statins' (atorvastatin, simvastatin and pravastatin).

·        They now cost the government A$955,051,083, an increase of nearly 5 million dollars from the 2004-2005 cost of $950,177,020.

·        The number of prescriptions is now 17,4219,273, an increase of nearly 1 million from the 2004-2005 number of 16,451,950.

·        The DDD/1000/day (ie the number of people in every thousand Australians who were taking the standard dose every day) now totals 189 (116+59+14), compared to the 2004-2005 total of 168. 

This means that, in 2004-2005 close to one in every six people (1:5.95) were taking a statin drug to lower blood lipids. Now, a year later, this figure is approaching one in five (1:5.29). (And this is independent of private prescriptions and prescriptions for other statins such as flurastatin).

 

In May 2006, I asked the following question:

With a lifestyle change, how many of the drugs listed in the above three tables would need to be consumed by so many people, at such a tremendous expense to the Australian government and the taxpayer?

I repeat my response to the question:

The lifestyle change needed to dramatically reduce the intake of these drugs would need to:
  • address in particular the epidemic of overweight/obesity
  • include a diet as outlined in ‘How to Live to 100+ Years Free from Symptoms and Disease’ - dominantly vegetarian, raw and aiming for 75%-80% of foods consumed to be alkali forming (see November 2005 newsletter “Acid Alkali Balance – The Ideal Diet”),
  • include regular exercise and stress management, as well as adequate relaxation and rest.

To take a drug is a quick fix. It takes time, discipline, motivation and understanding to embrace a healthy lifestyle, to prevent disease, and to reverse disease if already present. It is all too easy for the doctor to write a script for the quick fix, but surely the best approach is to identify the cause of the symptom and rectify it. A correct diet is one of the most significant aspects of the lifestyle that leads to Health and Longevity. 

My final word is unchanged.

………the word ‘MEDICINE’ is derived from the Latin Medico, and the literal translation of this word is ‘I drug’.   

** Copyright 2007: The Huntly Centre.

  

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