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STATISTICAL BRIEF #66:
Top 10 Outpatient Prescription Medicines Ranked by Utilization and Expenditures for the Elderly in the U.S. Community Population, 2002
Highlights
- Expenditures for prescribed medicines reported as purchased by the elderly in the U.S. community population totaled $49.9 billion in 2002, an increase of 12.6 percent from the $44.3 billion total reported in 2001, and an increase of 116 percent from the $23.1 billion total reported in 1996.
- In 2002, when ranked by total expenditures, the top 10 prescribed medicines totaled $12.4 billion, representing nearly one-fourth (24.8 percent) of total prescribed medicine expenditures by the elderly.
- Three cholesterol-lowering medicines, Lipitor, Zocor, and Pravachol, ranked first, second, and third in terms of total expenditures for prescribed medicines by the elderly in 2002 ($2.5 billion, $2.3 billion, and $1.1 billion, respectively).
- Lipitor ranked first for the elderly in terms of total expenditures ($2.5 billion) and total number of purchases (26.48 million) in 2002.
- In 2002, five antihypertensive medicines, Hydrochlorothiazide, Furosemide, Atenolol, Toprol, and Norvasc, made the 2002 top 10 when ranked by total purchases and totaled 105.51 million prescriptions, which represented 11.5 percent of all prescriptions purchased by the elderly.
Introduction
This Statistical Brief provides a summary of the top 10 outpatient prescription medicines for persons age 65 and older (elderly) in the U.S. civilian noninstitutionalized (community) population by utilization and expenditures, as reported by household respondents in calendar year 2002. The brief also provides trends in annual prescribed medicine expenditures by the elderly from 1996 to 2002.
The estimates in this brief are derived from prescribed medicine data in the Household Component of the 2002 Medical Expenditure Panel Survey (MEPS-HC). Over-the-counter medicines and free samples are not included in these estimates. All results discussed are statistically significant at the 0.05 level.
Findings
In 2002, the top 10 household-reported prescribed medicines for the elderly when ranked by annual expenditures totaled $12.4 billion. This represented nearly a quarter (24.8 percent) of the $49.9 billion total spent by the elderly on prescription medicines in 2002 (figure 1) and included the following:
Top 10 Prescribed Medicines for Persons Age 65 and Older, by Total Expenditures, 2002 |
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Rank |
Prescribed medicine name |
Total dollars (in billions) |
1 |
Lipitor |
$2.47 |
2 |
Zocor |
$2.28 |
3 |
Pravachol |
$1.13 |
4 |
Prilosec |
$1.04 |
5 |
Norvasc |
$1.02 |
6 |
Plavix |
$1.00 |
7 |
Fosamax |
$0.91 |
8 |
Prevacid |
$0.89 |
9 |
Celebrex |
$0.87 |
10 |
Atenolol |
$0.83 |
Total |
Total of top 10 |
$12.44 |
In 2002, the top three prescribed medicines for the elderly in terms of expenditures were all cholesterol-lowering medicines. Lipitor ranked first at $2.47 billion, Zocor ranked second at $2.28 billion, and Pravachol ranked third at $1.13 billion. These three medicines alone totaled $5.9 billion, and represented 11.8 percent of total prescription medicine expenditures by the elderly in 2002.
Ranking fourth and eighth in 2002 total prescription medicine expenditures for the elderly were two anti-ulcer medicines, Prilosec and Prevacid. Prilosec ranked fourth, with a total of $1.04 billion, and Prevacid eighth, with $0.89 billion. The total expenditures for these two medicines combined were $1.9 billion and represented 3.8 percent of total prescription medicine expenditures by the elderly in 2002.
Norvasc and Atenolol, two antihypertensive medicines, ranked fifth and tenth, with expenditures of $1.02 billion and $0.83 billion, respectively. The total for these two prescribed medicines was $1.9 billion and represented 3.8 percent of total prescription medicine expenditures by the elderly in 2002.
Plavix, a platelet aggregation inhibitor, ranked sixth in total prescription medicine expenditures by the elderly in 2002, with $1.00 billion. Fosamax, a bone resorption inhibitor, ranked seventh with $0.91 billion. Celebrex, a Cox-2 inhibitor non-steroidal anti-inflammatory, ranked ninth with $0.87 billion.
In 2002, the top 10 household-reported prescribed medicines for the elderly when ranked by total annual utilization totaled 195.83 million prescriptions. This represented 21.3 percent of the 919.03 million total prescription medicines purchased by the elderly in 2002 (data not shown) and included the following:
Top 10 Prescribed Medicines for Persons Age 65 and Older, by Total Utilization, 2002 |
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Rank |
Prescribed medicine name |
Total utilization (in millions of prescriptions) |
1 |
Lipitor |
26.48 |
2 |
Hydrochlorothiazide |
22.61 |
3 |
Furosemide |
21.96 |
4 |
Atenolol |
21.93 |
5 |
Toprol |
21.41 |
6 |
Synthroid |
19.76 |
7 |
Zocor |
17.92 |
8 |
Norvasc |
17.60 |
9 |
Premarin |
13.74 |
10 |
Fosamax |
12.42 |
Total |
Total of top 10 |
195.83 |
Lipitor ranked first in terms of utilization by the elderly with a total of 26.48 million prescriptions purchased in 2002. Zocor ranked seventh in terms of total number of prescriptions purchased with 17.92 million prescriptions. The utilization for these two cholesterol-lowering medicines combined totaled 44.40 million prescriptions, which represented 4.8 percent of total prescribed medicine purchases by the elderly in 2002.
In 2002, antihypertensive medicines ranked second, third, fourth, fifth, and eighth in terms of number of prescriptions purchased by the elderly. These medicines were Hydrochlorothiazide (22.61 million), Furosemide (21.96 million), Atenolol (21.93 million), Toprol (21.41 million) and Norvasc (17.6 million), respectively. The combined total for these antihypertensive medicines totaled 105.51 million prescriptions and represented 11.5 percent of the total prescriptions purchased by the elderly in 2002.
Synthroid, a thyroid medicine, was sixth when ranked by total purchases, with 19.76 million prescriptions purchased by the elderly in 2002.
Rounding out the top 10 prescriptions purchased by the elderly in 2002 were Premarin and Fosamax in the ninth and tenth spots. Premarin, an estrogen, was ninth with 13.74 million prescriptions, and Fosamax, a bone resorption inhibitor, was tenth with 12.42 million prescriptions purchased.
Data Source
The estimates in this Statistical Brief are drawn from analyses using the 1996-2002 MEPS prescribed medicines public use files: HC-010A, HC-016A, HC-026A, HC-033A, HC-051A, HC-059A, and HC-067A.
About MEPS-HC
MEPS-HC is a nationally representative longitudinal survey that collects detailed information on health care utilization and expenditures, health insurance, and health status, as well as a wide variety of social, demographic, and economic characteristics for the civilian noninstitutionalized population. It is cosponsored by the Agency for Healthcare Research and Quality and the National Center for Health Statistics.
For more information about MEPS, call the MEPS information coordinator at AHRQ (301-427-1406) or visit the MEPS Web site at http://www.meps.ahrq.gov/.
References
For a detailed description of the MEPS-HC survey design, sample design, and methods used to minimize sources on nonsampling error, see the following publications:
Cohen, J. Design and Methods of the Medical Expenditure Panel Survey Household Component. MEPS Methodology Report No. 1. AHCPR Pub. No. 97-0026. Rockville, Md.: Agency for Health Care Policy and Research, 1997.
Cohen, S. Sample Design of the 1996 Medical Expenditure Panel Survey Household Component. MEPS Methodology Report No. 2. AHCPR Pub. No. 97-0027. Rockville, Md.: Agency for Health Care Policy and Research, 1997.
Suggested Citation
Stagnitti, M. N. Top 10 Outpatient Prescription Medicines Ranked by Utilization and Expenditures for the Elderly in the U.S. Community Population, 2002. Statistical Brief #66. February 2005. Agency for Healthcare Research and Quality, Rockville, MD. http://meps.ahrq.gov/mepsweb/data_files/publications/st66/stat66.shtml
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