The Collison Newsletter January 2009

 

                DRUGS – The TOP 10 for 2007-2008*    

My July 2006, February 2007 and January 2008 newsletters discussed the ‘Top 10 Drugs’ for 2004-2005, 2005-2006 and 2006-2007 respectively.

 

The Australian Prescriber, volume 31, number 6, December 2008, lists the top10 drugs for 2007-2008. These were the subsidised drugs (that is, those part-paid by the Australian Government direct to the pharmaceutical companies) prescribed under the PBS (Pharmaceutical Benefits Scheme) or RPBS (Repatriation PBS). The data supplied does not include private prescriptions (ie, those fully paid by the patient). The source of the information was the Drug Utilisation Sub-committee Drug Utilisation Database (Commonwealth of Australia), as at 30 October 2008.

 

The ’quick fix’ mentality continues to be the ’norm’ for orthodox medicine. (The ‘quick fix’ concept is explained in ‘Feeling Worse Before Felling Better’, Collison, 2002.)

Table 1. Top 10 drugs by cost to the Government, 2007-2008. 

Drug Cost A$ DDD/1000 pop/day*# Prescription Count # 
1.  atorvastatin585,491,600136.21510,542,015
2.  simvastatin237,274,76352.9965,773,055
3.  clopidogrel196,649,8179.7762,636,907
4.  esomeprazole184,420,07819.4455,221,504
5.  salmeterol &  fluticasone160,894,401//////2,874,427
6.  olanzapine158,220,4503.051864,937
7.  omeprazole108,931,73016.6783,702,832
8.  rosuvastatin104,846,8409.2481,674,364
9.  venlafaxine104,082,53113.1962.644,753
10. tiotropium100,464,4205.6621,437,217
  

*

DDD/1000 pop/day is the defined daily dose/thousand population/day.
#Prescription count and DDD are for PBS and RPBS only
////Combination drugs do not have a DDD allocated
  

atorvastatin

Brand Name: Lipitor
 Also an ingredient in Caduet
 Hypolipidaemic agent. A ‘statin’
simvastatinBrand Names: multiple including Lipex, Ransim, Simvar, Zimstat and Zocor.
 Hypolipidaemic agent.A ‘statin’
clopidogrelBrand Names: Iscover, Plavix
 Platelet aggregation inhibitor
esomeprazoleBrand Name: Nexium
 Proton pump inhibitor. Treatment of peptic ulcers
salmeterol & fluticasoneBrand Name: Seretide
 For asthma prophylaxis
olanzapineBrand Name: Zyprexa
 Antipsychotic agent.
 Treatment of schizophrenia and related psychoses
omeprazoleBrand Names include: Klacid HP 7, Meprazol & Probitor
 Proton pump inhibitor. Treatment of peptic ulcers
rosuvastatinBrand Name: Crestor
 Hypolipidaemic agent. A ‘statin’
venlafaxineBrand Name: Efexor
 Selective serotonin reuptake inhibitor.
 Treatment of depression.
tiotropiumBrand Name: Spiriva
 For asthma prophylaxis

Table 2. Total Cost to the Government (A$) of the Top 10 Drugs 

2004-2005

2005-20062006-20072007-2008
1,949,788,1801,982,069,6291,919,232,0001,941,276,630
 

It can be seen that the cost to the Government (taxpayers) has changed but little over the last four years.

 

Why has there been little change, with an increasing population and at least the same incidence of disease, if not greater?  The answer would appear to be related to increased generic prescribing, and the prescribing of ‘older’ drugs where the patent (valid for 19 years) has expired. Most of the top10 drugs are still protected by patent.

 

Statin Drugs

 

The ‘Top 10’ continues to include three ‘statin’ drugs used to treat elevated cholesterol levels. The combined cost of these three (atorvastatin, simvastatin and rosuvastatin) is A$ 927,613,203, from just under 18 million prescriptions. This is $37 million less than 2006-2007 which is a significant reversal of the progressive increasing costs of these statin drugs over the previous 3 years.

 

The cost to the Government of the top two drugs, both statins, the same two as for the last four years is A$ 822,766,363. This is the first time a reduction (nearly $50 million) has occurred since 2004, and indeed since the introduction of these drugs. See Table 3.

 

Table 3. Cost to the Government (A$) of the Top 2 Drugs.

 

2004-2005

2005-20062006-20072007-2008
830,589,303852,605,364871,461,773822,766,363

Comments 

There are thousands of drugs listed in MIMS, that can be, and are, prescribed to treat diseases and symptoms. This is the ‘quick fix’, and apart from the ‘top10’, many of these drugs (indeed hundreds) are listed on the PBS and RPBS, all with a cost to the consumer as well as the Government. See www.mims.com.au

 

With a lifestyle change, many of the drugs consumed by so many people, at such a tremendous expense to the Australian Government and the taxpayer, would not need to be taken.

 

Lifestyle changes required to dramatically reduce the intake of these drugs would need to:

  • address in particular the epidemic of overweight/ obesity. The Metabolic Syndrome (see my October 2008 newsletter ‘Metabolic Syndrome’) is increasingly common and includes hyperlipidaemia, hypertension, abdominal obesity, and diabetes.
  • include a diet as outlined in my book How to Live to 100+ Years Free from Symptoms and Disease’.  This is dominantly vegetarian, raw and aiming for 75-80% of foods consumed to alkali forming (see my November 2005 newsletter ‘Acid Alkali Balance - The Ideal Diet’).
  • include regular exercise and stress management, as well as adequate rest and relaxation.
 

To take a drug is a quick fix. For a doctor to prescribe a drug is the quick and easy way. But is the prescribing of drugs the best way? In the acute management of crises, for example a fractured bone or severe congestive heart failure, appropriate medication is of course indicated and necessary, and could well be life-saving. In the case of chronic recurring symptoms, for example, headaches, it is best to identify the cause and treat it rather than just prescribe drugs, in various combinations, for pain relief.

 

It takes time, discipline, motivation and understanding to find the underlying causes of diseases and their associated symptoms and to deal with them. It takes the same dedication to encourage an individual to embrace a healthy lifestyle in order to prevent disease and reverse disease if already present. Needless to say, not only should your health care professional guide you in this and supervise your progress, but you need to cooperate with the advice given.

 

If this approach to your disease and symptoms is not given, and the quick fix of a prescription only is written out and handed to you, you will need to seek help elsewhere. My two books ‘How to Stop Feeling so Awful’ and ‘How to live to 100+ Years Free from Symptoms and Disease’ (see home page) will help point you in the right direction.

 

The choice is yours.

 

*Copyright 2009: The Huntly Centre.

Disclaimer: All material on the Huntlycentre.com.au website is provided for informational or educational purposes only. Consult a health professional regarding the applicability of any opinions or recommendations expressed herein, with respect to your symptoms or medical condition.

 

 

 

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