Effects of non-optimized medications

Although the prices of drugs have risen steeply in recent times, prescription drugs are in reality much costlier than what is priced in terms of dollars and cents in retail pharmacies. A recent study was conducted by pharmaceutical researchers at the University of California in San Diego, USA.

The impact of non-optimized medications is surely dangerous: it can leads to illness and death in patients. What is frightening to know that the gruesome impact of non-optimized medications has now translated into a parallel market of $528.4 billion annually. This implies that non-optimized medications cause a 16% increase in medical expenditure in the USA, as of latest industry reports in 2016.

In the journal Annals of Pharmacology, the analysis report was published online in March 2016. The news has created a ripple effect in the pharmaceutical and healthcare sector in the USA. The research study was supervised by Dr. Jonathan Watanbe, PharmD. He is associate professor of clinical pharmacy at the Skaggs School of Pharmacy, which is affiliated to the University of San Diego in California. In an ideal situation, patients visit a doctor whenever they are sick or battling a chronic, progressive disease.

The healthcare professional prescribes medications, and patients feel better when they complete their due course of medication as per instructions. However, many a times the prescription dosage is not in agreement with the severity of your illness. This means the medication is not optimized to suit patients’ needs. Alternatively, a patient may not take the prescription drug as per indicated. In such scenarios, the patient would surely develop a adverse reaction or succumb to a new health problem.

The other collaborators in this path-breaking research study are as follows: Dr. Jan Hirsch, PhD, professor of clinical pharmacy at the Skaggs School of Pharmacy and Terry McInnis, MD of Laboratory Corporation of America. These researchers have lucidly explained the impact of non-optimized medications with a real-life scenario: Suppose a patient is down with flu and visits the emergency department of the hospital in his or her locality. A doctor would normally prescribe Tamiflu, but the patient does not take up the requisite dosage as it is too expensive.

The patients’ symptoms worsen over a period of time and he or she ultimately lands up in the Intensive Care Unit (ICU). Now, this translates into a huge financial set-back to the patient and the hospital. If the patient has been paying regular premiums to the medical insurance company, then it can certainly lead to a huge financial drain to the company. Nonetheless, the patient still has to go through a lot of paperwork to receive medical reimbursement from the company. In other words, a small problem of improper dosage and expensive medications has now snow-balled into a big problem.

The problem of non-optimized medications is not just restricted to improper dosage of medications. Watanbe has also analyzed instances where a certain medication can cause other health issues. For example, a patient is administered a steroidal drug for two years to combat epileptic fits; however, the impact of steroid is detrimental to the patients’ health.

The patient develops diabetes due to the administration of steroidal drug. Similarly, an ACE inhibitor is the most preferred drug used to combat blood pressure in patients. However, the most common side-effect of this drug is frequent cough. The patient consumes an over-the-counter medication to combat cough-and-cold and this further causes a steep rise in blood pressure. Moreover, the patient feels drowsy during daytime and ultimately falls down.

In both the scenario, a particular drug treatment used to combat a chronic ailment further leads to more complications. The researchers have developed decision-outcome models to estimate the financial impact of these situations, which includes visits to emergency department, intensive care units, additional medications, long-term medical treatment, etc.

The consequences have been shocking enough to compel changes in medical interventions: non-optimized medications certainly cause other illnesses and its annual cost is in the range of 490 to 670 billion dollars. At an individual level, the annual cost can be as high as $2500. It is important to note that this encompasses just medical treatments and does not include transportation and loss of productivity due to illness.

The last estimates were presented in the year 2008 and they seem relatively demure at $290 billion annually. Thus, the impact of non-optimized medications was just 13 percent of the US healthcare system. This implies that a phenomenal rise has occurred within a duration of eight years at 2016.

With a capitalistic economy, healthcare costs are at an all-time high; however, under the ambit of Obama healthcare, more than 20 million people were brought under the umbrella of Affordable Care Act. Thus, more than 20 million people could now access prescription drugs, a scenario that was not visible in the year 2008.

Consequently, the instance of non-adherence to prescribed dosages has increased phenomenally, leading to secondary health issues that are caused by adverse effects of long-term medication. It is not just non-adherence of medications, but also instances where healthcare professionals fail to prescribe an accurate medication region in accordance with the presented symptoms.

Each case is different, so the doctors should take into account all factors in order to provide optimized dosages to each patient rather than just considering external symptoms. For example, a diabetic patient with an attack of flu may need a more aggressive treatment regimen as compared to a healthy patient. This is because the immunity levels of diabetic patients are at an all-time low even when it is well-controlled with medications.

To overcome all these disturbing trends, Watanbe and his associates have proposed a novel model that improves patient outcomes: currently, pharmacists do not play an important role in analyzing each patients’ case. The direct contact is between the patient, nurse, and a trained medical doctor.

They have proposed a comprehensive healthcare management plan in which trained pharmacists must work along with the trained doctor to analyze the illness of each patient. This is because pharmacists are more trained in medications and their adverse effects, while a trained medical doctor is more trained in pharmacology and human body analysis.



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