Pill-pushing is a widespread problem, especially for older patients. Over the last two decades, the number of Americans taking multiple prescription drugs has grown rapidly. The proportion of adults taking five or more types of drugs rose from 8.2% to 15% between 2000 and 2012. For many, prescribed medications are beneficial and lifesaving. However, hundreds of millions of these prescriptions are inappropriate, unnecessary, or dangerous.
A Pill for Every Ill
There’s a shared expectation among many patients and doctors that there’s a “pill for every ill.” Pill pushing is a widespread problem, especially for patients 65 years or older. Older patients account for more than 41% of Medicare expenses for prescription medicine. Many are using at least one inappropriately prescribed drug.
More than 1.5 million Americans are hospitalized and more than 100,000 die every year from generally avertible adverse reactions to unnecessary medicines. Here are common sins of pill-pushing:
- A drug is administered to treat a problem that should first be treated with lifestyle changes.
- A drug is used to treat an adverse reaction to another drug, which manifests as a disease. Instead of replacing the drug or lowering the dose, the doctor prescribes a second drug.
- The medical condition is entirely unresponsive to treatment or doesn’t merit treatment with some medications.
- Multiple drugs in a similar therapeutic category are prescribed, the extra ones not contributing to the effectiveness of the first but evidently augmenting the risk to the patient.
- Treatment by medication is preferred for a medical problem, but the physician fails to prescribe the safest, most effective drug.
- Multiple medications interact, exposing a patient to the risk of serious injury or death.
Overprescribed medication categories include opioids for chronic pain, levothyroxine for subclinical hypothyroidism, proton pump inhibitors for indigestion, and antidepressants for subsyndromal levels of depression.
Pharmaceutical Companies Influence Prescriptions
The pharmaceutical industry spends more than $21 billion on direct-to-consumer drug advertisements and promotional tricks targeting doctors. Many doctors are heavily influenced by pharmaceutical companies through visits from sales reps, informational conferences, free samples and meals, free medical books in exchange for receiving information about certain drugs, and sponsorship of continuing medical education courses.
Drugmakers also fund studies after the approval of a drug to promote off-label use or identify a drug as safer than another brand. Published papers from those trials tell prescribers that the drug is suitable for a larger population. With this, doctors can be swayed toward more favorable impressions about certain medications.