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Medicare drug tab $2.55B for older and disabled Ohioans

New research shows most Medicare prescriptions were for conditions associated with obesity.

Elderly and disabled Ohioans were charged nearly $2.6 billion in drug costs in 2010, most of it spent on prescriptions for medications to treat hypertension, high blood pressure and high cholesterol, according to a report Monday from the independent investigative news organization ProPublica.

Ohio pharmacies filled nearly 3 million prescriptions for just two common treatments for high cholesterol and hypertension — Simvastatin and Lisinopril — alone in 2010 at a cost of more than $41 million, based on ProPublica’s examination of Medicare Part D prescription data. Medicare is the federal program that pays for certain health care expenses for the disabled and people aged 65 or older.

Last year about 2 million Ohioans were covered by Medicare. That number amounts to one in six Ohioans enrolled in the federal program, with about 85 percent of them senior citizens.

It is difficult to say precisely why prescriptions for high cholesterol and hypertension medications were so prevalent in Ohio, but at least one local expert attributes the prescriptions to the growing obesity epidemic in Ohio and across the country.

“Obesity and high blood pressure, high cholesterol and many other conditions are absolutely linked,” said Richard Cohen, a dietitian at Kettering Weight Loss Solutions. “It should be no surprise that states with the highest obesity rates also have high blood pressure, high cholesterol and hypertension. Just about everybody we see is on some kind of statin to lower cholesterol.”

Ohio has the eighth-highest obesity rate in the country, according to the latest Gallup-Healthways Well-Being Index, which found about 30 percent of adult Ohioans are obese, compared to about 26 percent of adults nationally.

While you do not have to be overweight or obese to have hypertension or high blood pressure, obesity is an established risk factor for those conditions. The only thing riskier is not seeking treatment, Cohen said.

“If you’re a doctor, you want to help people with a lifestyle change, but it takes a little while to accomplish that,” he said. “In the meantime, you can’t let people walk around with high blood pressure because they could have stroke. So you’ve got to give them medication for that.”

ProPublica, which reviewed 1.1 billion prescriptions written by 1.7 million doctors, nurses and other providers between 2007 and 2010, found widespread use of antipsychotics, narcotics and other drugs dangerous for older adults.

ProPublica went on to report that the Centers for Medicare & Medicaid Services has done little to monitor potentially dangerous prescribing patterns or doctors who frequently prescribe dangerous medications through Medicare Part D.

While prescriptions for high blood pressure and hypertension are generally less lethal, all drugs have potentially dangerous side effects, said Ernest Boyd, executive director of the Ohio Pharmacists Association.

“There’s no prescription or over-the-counter drug that doesn’t have some kind of problem with it if you either overuse it or put it in combination with certain other medications,” Boyd said. “Many times people go to two or three doctors, and by they time they combine all these meds they could have a problem.

“That’s why it’s important for people to have a pharmacist that they can ask those kinds of questions of about interactions and whether a drug has a regular side effect that I should be aware of,” he said.

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