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STATISTICAL BRIEF #65:
Top 10 Outpatient Prescription Medicines Ranked by Utilization and Expenditures for the Near Elderly in the U.S. Community Population, 2002


February 2005
Marie N. Stagnitti, MPA

Highlights

  • Expenditures for prescribed medicines by the near elderly reported as purchased by respondents in the U.S. community population totaled $31.1 billion in 2002, an increase of 19.6 percent from the $26.0 billion total reported in 2001, and an increase of 180 percent from the $11.1 billion total reported in 1996.
  • In 2002, when ranked by total expenditures, the top 10 prescribed medicines for the near elderly totaled $7.39 billion, representing nearly one-fourth (23.8 percent) of total prescribed medicine expenditures by those age 55-64.
  • Lipitor, a cholesterol-lowering medicine, ranked number one in terms of total utilization (21.24 million prescriptions, representing 3.9 percent of total prescriptions purchased) and total expenditures ($1.80 billion, representing 5.8 percent of total prescribed medicine expenditures) for the near elderly in 2002.
  • Lipitor, Zocor, and Pravachol, the three cholesterol-lowering prescribed medicines that ranked in the 2002 top 10 list for total expenditures for the near elderly, totaled $3.4 billion and accounted for 10.9 percent of total prescribed medicine expenditures by those age 55-64 in 2002.
  • In 2002, two Cox-2 Inhibitor nonsteroidal anti-inflammatory medicines, Celebrex and Vioxx, made the top 10 list for the near elderly when ranked by total purchases, with total combined expenditures of $1.1 billion, which represented 3.5 percent of total prescription medicine expenditures by those age 55-64.

Introduction


This Statistical Brief provides a summary of the top 10 outpatient prescription medicines for the near elderly, persons age 55-64, 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 for the near 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 near elderly when ranked by annual expenditures totaled $7.39 billion. This represented 23.8 percent of the total $31.1 billion spent by the near elderly on prescription medicines in 2002 (figure 1) and included the following:

Top 10 Prescribed Medicines for Persons Age 55-64, by Total Expenditures, 2002
Rank
Prescribed medicine name
Total dollars (in billions)
1
Lipitor
$1.80
2
Zocor
$1.14
3
Prevacid
$0.74
4
Celebrex
$0.68
5
Premarin
$0.63
6
Prilosec
$0.58
7
Norvasc
$0.52
8
Vioxx
$0.44
9
Pravachol
$0.44
10
Glucophage
$0.42
Total
Total of top 10
$7.39


In 2002, the top two prescribed medicines for the near elderly in terms of expenditures were cholesterol-lowering medicines. Lipitor ranked first at $1.80 billion, and Zocor ranked second at $1.14 billion. A third cholesterol-lowering medicine, Pravachol, ranked ninth at $0.44 billion. Expenditures for these three medicines totaled $3.4 billion, which represented 10.9 percent of total prescription medicine expenditures by the near elderly in 2002.

Ranking third and sixth in 2002 total prescription medicine expenditures for the near elderly were two anti-ulcer medicines, Prevacid and Prilosec. Prevacid ranked third, with $0.74 billion, and Prilosec sixth, with $0.58 billion. The total expenditures for these two medicines combined were $1.3 billion and represented 4.2 percent of total prescription medicine expenditures by the near elderly in 2002.

Two Cox-2 Inhibitor non-steroidal anti-inflammatory medicines, Celebrex and Vioxx, ranked fourth and eighth in total prescription medicine expenditures by the near elderly in 2002, with $0.68 billion and $0.44 billion, respectively. Total expenditures for these two medicines combined were $1.1 billion and represented 3.5 percent of total prescription medicine expenditures by the near elderly in 2002.

The remaining 2002 top 10 prescribed medicines in terms of total expenditures by the near elderly were the following: Premarin, an estrogen, ranked fifth with $0.63 billion, Norvasc, an antihypertensive medicine, ranked seventh with expenditures of $0.52 billion, and Glucophage, an antihyperglycemic agent, ranked tenth with $0.42 billion.

In 2002, the top 10 household-reported prescribed medicines for the near elderly when ranked by total annual utilization accounted for 112.71 million prescriptions. This represented one-fifth (20.9 percent) of the 538.98 million total prescription medicines purchased by the near elderly in 2002 (data not shown) and included the following:

Top 10 Prescribed Medicines for Persons Age 55-64, by Total Utilization, 2002
Rank
Prescribed medicine name
Total utilization (in millions of prescriptions)
1
Lipitor
21.24
2
Premarin
15.04
3
Hydroclorothiazide
11.58
4
Atenolol
11.50
5
Synthroid
11.25
6
Zocor
10.56
7
Toprol
10.26
8
Norvasc
8.34
9
Celebrex
6.96
10
Prevacid
5.98
Total
Total of top 10
112.71


Lipitor ranked first in terms of utilization by the near elderly, with a total of 21.24 million prescriptions purchased in 2002. Zocor ranked sixth in terms of total number of prescriptions purchased, with 10.56 million prescriptions. The utilization for these two cholesterol-lowering medicines combined totaled 31.77 million prescriptions, which represented 5.9 percent of total prescribed medicine purchases by the near elderly in 2002.

Premarin, an estrogen, ranked second in terms of prescriptions purchased in 2002, with 15.04 million prescriptions, which represented 2.8 percent of total prescription medicines purchases by the near elderly in 2002.

In 2002, antihypertensive medicines ranked third, fourth, seventh, and eighth in terms of number of prescriptions purchased by the near elderly. These medicines were Hydrochlorothiazide (11.58 million), Atenolol (11.50 million), Toprol (10.26 million), and Norvasc (8.34 million), respectively. The combined total for these antihypertensive medicines totaled 41.68 million prescriptions and represented 7.7 percent of the 538.98 billion prescriptions purchased by the near elderly in 2002.

Synthroid, a thyroid medicine, was fifth when ranked by total purchases, with 11.25 million prescriptions purchased by the near elderly in 2002.

Rounding out the rankings by number of prescriptions purchased by the near elderly in 2002 were Celebrex and Prevacid in the ninth and tenth spots. Celebrex, a Cox-2 Inhibitor non-steroidal antiinflammatory, was ninth with 6.96 million prescriptions, and Prevacid, an anti-ulcer medicine, was tenth with 5.98 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 Near Elderly in the U.S. Community Population, 2002. Statistical Brief #65. February 2005. Agency for Healthcare Research and Quality, Rockville, MD. http://meps.ahrq.gov/mepsweb/data_files/publications/st65/stat65.shtml
Table containing figure values follows image.
Figure 1. Total prescription drug expenditures for persons age 55-64 (near elderly) in the U.S. civilian noninstitutionalized population, 1996-2002
1996199719981999200020012002
Billions of dollars11.112.413.817.019.026.031.1
Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey, 2002

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