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Reports show prescriptions for obesity-related ills rising. Some worry it's shortcut fix
By Stephanie Saul
New York Times
Published on Saturday, Jul 26, 2008
A growing number of American children are taking drugs for a wide range of chronic conditions related to childhood obesity, according to prescription data from three large organizations.
The numbers, from pharmacy plans Medco Health Solutions, Express Scripts and the marketing data collection company Verispan, indicate that hundreds of thousands of children are taking medication to treat Type 2 diabetes, high blood pressure, high cholesterol and acid reflux — all problems linked to obesity that were practically unheard of in children two decades ago.
The data, which the firms either disclosed publicly in recent months or provided at the request of the New York Times, show that concerns that children will be taking adult medications — heightened recently by a controversial recommendation by a national pediatricians group — already are a reality.
Earlier this month, the American Academy of Pediatrics said that more children, as young as 8, should be given cholesterol-lowering drugs. The recommendation was attacked by some experts as a license to put children on grown-up drugs.
While the drugs do help treat the conditions, some doctors fear they are simply a shortcut fix for a problem better addressed by exercise and diet. Even so, some pharmaceutical companies are developing new versions of adult medications, including flavored ones, for children.
While some of the percentage increases in the three analyses are
dramatic, doctors emphasize that prescriptions of these drugs for children still represent less than 1 percent of their sales.
Express Scripts and Medco developed estimates of how many children might be taking such medications by extrapolating their own data — involving more than 4 million children — across the broader population.
The companies use different assumptions to reach their estimates, but the data suggest that at least several hundred thousand children are on various obesity-related medications.
The greatest increase occurred in medications for Type 2 diabetes, with Medco's data showing a 151 percent jump from 2001 to 2007.
Medco's data, released in May, showed that use of drugs to treat acid reflux problems in children, often aggravated by obesity, increased 137 percent over seven years. Its analysis also showed an 18 percent increase in drugs to treat high blood pressure and a 12 percent increase in cholesterol-lowering medications during the seven-year period.
Express Scripts found a 15 percent increase over three years in drugs to treat cholesterol and other fats in the blood, a category that is primarily statins.
''We were amazed at how quickly the rates of drugs used have climbed,'' said Dr. Donna R. Halloran, an assistant professor at Saint Louis University who worked on the Express Scripts analysis, presented at a meeting of the American Public Health Association in November.
Verispan data recorded a 13 percent increase in high blood pressure prescriptions in the under-19 age group from 2005 to 2007. Its numbers show, however, a less than 1 percent increase during the period in cholesterol-lowering drugs in children.
Doctors and some financial analysts have said that less dramatic increases in cholesterol drugs compared with some other medications — seen in all three analyses — reflect a wariness by some doctors about using those drugs in children.
Still, some experts have expressed concern that the increases in many of these obesity-related drugs reflect a systemic failure, with doctors and parents turning to them because they find lifestyle changes too difficult to impose or enforce.
Experts say the trend could balloon medical costs. As many as 30 percent of children nationwide are overweight. And children who start such medication often rely on the drugs for a lifetime and are prone to health problems as adults.
Despite a push during the last 10 years by the Food and Drug Administration to foster drug studies in children, some experts believe that clinical studies in children have not been extensive enough. And adult doses often are not correct for children.
A growing number of American children are taking drugs for a wide range of chronic conditions related to childhood obesity, according to prescription data from three large organizations.
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