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DRUGS – THE TOP 10 for 2005-2006 **
In my May 2006 Newsletter, the top 10 dugs for 2004-2005, as published in the ‘Australian Prescriber’ (February 2006), were discussed.
The ‘Australian Prescriber’, volume 29, number 6, December 2006, lists the top 10 drugs for 2005-2006.
It should be noted that these were the subsidised drugs (ie those part-paid by the Australian Government direct to the pharmaceutical companies) prescribed under the PBS (Pharmaceutical Benefits Scheme) or RPBS (Repatriation Pharmaceutical Benefits Scheme). The following tables do not include private prescriptions (ie those fully paid by the patient).
The Top 10 for 2005-2006 in the 3 categories (defined daily dose (DDD) / 1000 population / day, prescription counts and cost to the government) were essentially unchanged from 2004-2005. There was one deletion and one addition in table 2 (prescription counts). The deleted drug was a bronchodilator (salbutamol) and the new one was an antihypertensive agent (perindopril).
The 3 tables setting out the top 10 drugs in the 3 categories are set out below, listing both financial years 2004-2005 and 2005-2006, for comparison. (Refer to my May 2006 newsletter for a full description of the generic names as set out in the tables).
Table 1. Top 10 drugs supplied by DDD/1000 pop/day
| Drug | 2004 - 2005 | 2005 - 2006 | ||
PBS/RPBS | PBS/RPBS | |||
| atorvastatin | 1 | 98.173 | 1 | 116.088 |
| simvastatin | 2 | 55.967 | 2 | 58.707 |
| ramipril | 3 | 33.741 | 3 | 35.897 |
| diltiazem hydrochloride | 4 | 30.097 | 4 | 26.970 |
| omeprazole | 5 | 20.628 | 5 | 19.531 |
| irbesartan | 6 | 20.169 | 6 | 17.971 |
| salbutamol | 7 | 18.844 | 7 | 18.073 |
| frusemide | 8 | 18.775 | 8 | 18.420 |
| aspirin | 9 | 18.162 | 9 | 18.047 |
| sertraline | 10 | 17.604 | 10 | 18.039 |
| Drug | 2004 - 2005 | 2005 - 2006 | ||
PBS/RPBS | PBS/RPBS | |||
| atorvastatin | 1 | 8,074,202 | 1 | 9,045,273 |
| simvastatin | 2 | 6,275,577 | 2 | 6,355,305 |
| paracetamol | 3 | 4,772,865 | 3 | 4,205,023 |
| omeprazole | 4 | 4,411,857 | 4 | 4,180,429 |
| irbesartan | 5 | 3,370,315 | 8 | 3,025,037 |
| atenolol | 6 | 3,247,475 | 6 | 3,259,401 |
| salbutamol | 7 | 3,062,355 | ||
| esomeprazole | 8 | 2,983,645 | 5 | 3,715,500 |
| irbesartan with hydrochlorothiazide | 9 | 2,938,448 | 10 | 2,962,120 |
| ramipril | 10 | 2,903,048 | 9 | 3,024,099 |
| perindopril | 7 | 3,124,409 | ||
perindopril (erbumine)
Brand Names: Perindopril (Chemmart, TerryWhtie Chemists,GenRx), Coversyl Plus
perindopril (arginine)
Brand Name: Coversyl
ACE inhibitor. Antihypertensive agent
Table 3. Top 10 drugs by cost to Government.
| Drug | 2004-2005 | 2005-2006 | ||||
| Cost to Government ($A) | Cost to Government ($A) | Prescriptions PBS/RPBS | DDD/1000/day PBS/RPBS | |||
| atorvastatin | 1 | 460,930,251 | 1 | 522,357,695 | 9,045,273 | 116.088 |
| simvastatin | 2 | 369,659,052 | 2 | 330,247,669 | 6,355,305 | 58.702 |
| omeprazole | 3 | 177,075,832 | 7 | 149,094,755 | 4,180,429 | 19.531 |
| fluticasone with salmeterol | 4 | 165,690,424 | 5 | 165,917,558 | 2,839,015 | * |
| clopidogrel | 5 | 151,235,466 | 4 | 169,947,052 | 2,179,960 | 8.485 |
| olanzapine | 6 | 149,497,256 | 6 | 154,623,092 | 745,603 | 3.016 |
| esomeprazole | 7 | 143,233,727 | 3 | 169,953,743 | 3,715,500 | 14.265 |
| pravastatin | 8 | 119,587,717 | 10 | 102,445,719 | 2,018,695 | 13.934 |
| alendronic acid | 9 | 108,587,183 | 8 | 113,917,837 | 2,297,414 | 9.177 |
| pantoprazole | 10 | 104,291,272 | 9 | 103,564,509 | 2,733,589 | 11.603 |
(* combination drugs do not have a DDD allocated)
The total cost to the government (ie to the taxpayer) of the top 10 drugs (table 3) for 2005-2006 was A$1,982,069,629, just under 2 billion dollars. This is an increase of A$32,281,449 from the 2004-2005 cost of $1,949,788,180.
Again, let us look at the three 'statins' (atorvastatin, simvastatin and pravastatin).
· They now cost the government A$955,051,083, an increase of nearly 5 million dollars from the 2004-2005 cost of $950,177,020.
· The number of prescriptions is now 17,4219,273, an increase of nearly 1 million from the 2004-2005 number of 16,451,950.
· The DDD/1000/day (ie the number of people in every thousand Australians who were taking the standard dose every day) now totals 189 (116+59+14), compared to the 2004-2005 total of 168.
This means that, in 2004-2005 close to one in every six people (1:5.95) were taking a statin drug to lower blood lipids. Now, a year later, this figure is approaching one in five (1:5.29). (And this is independent of private prescriptions and prescriptions for other statins such as flurastatin).
In May 2006, I asked the following question:
With a lifestyle change, how many of the drugs listed in the above three tables would need to be consumed by so many people, at such a tremendous expense to the Australian government and the taxpayer?
I repeat my response to the question:
The lifestyle change needed to dramatically reduce the intake of these drugs would need to:
To take a drug is a quick fix. It takes time, discipline, motivation and understanding to embrace a healthy lifestyle, to prevent disease, and to reverse disease if already present. It is all too easy for the doctor to write a script for the quick fix, but surely the best approach is to identify the cause of the symptom and rectify it. A correct diet is one of the most significant aspects of the lifestyle that leads to Health and Longevity.
My final word is unchanged.
………the word ‘MEDICINE’ is derived from the Latin Medico, and the literal translation of this word is ‘I drug’.
** Copyright 2007: The Huntly Centre.
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