January 26, 2007, Issue No. 219
AHRQ News and Numbers
In 2004, Americans spent $32 billion on cardiovascular drugs, putting them at the top of the five costliest classes of drugs prescribed by doctors for people age 18 and over. The five costliest classes of drugs, including cardiovascular medications, central nervous system agents, hormones, anti-cholesterol drugs, and antidepressants, together accounted for two thirds—$119 billion—of the $181 billion in total expenditures spent on outpatient prescription medications. [Source: Agency for Healthcare Research and Quality (AHRQ), MEPS Statistical Brief No. 154: The Top Five Therapeutic Classes of Outpatient Prescription Drugs Ranked by Total Expense for Adults Age 18 and Older in the U.S. Civilian Noninstitutionalized Population, 2004 (PDF Help)].
Today's Headlines
1. AHRQ Study Finds Newer Class of Antidepressants Similar in Effectiveness, But Side Effects Differ
2. Increased Use of Prescription Medicines Changing Health Care Spending Patterns
3. AHRQ Resources for Pandemic Flu Available
4. Highlights From Our Most Recent Monthly Newsletter
5. AHRQ Vacancy Announcement Posted
6. AHRQ in the Professional Literature
1. AHRQ Study Finds Newer Class of Antidepressants Similar in Effectiveness, But Side Effects Differ
Today's most commonly prescribed antidepressants are similar in effectiveness to each other but differ when it comes to possible side effects, according to an AHRQ analysis. The findings, based on a review of nearly 300 published studies of second-generation antidepressants, show that about 6 in 10 adult patients get some relief from the drugs. About 6 in 10 also experience at least one side effect, ranging from nausea to sexual dysfunction. Patients who don't respond to one of the drugs often try another medication within the same class. About one in four of those patients recover, according to the review.
Second-generation antidepressants, which include selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs), are often prescribed because first-generation antidepressants (such as tricyclic antidepressants, or TCAs) can cause intolerable side effects and carry high risks. The analysis compared the drugs' benefits and risks in the treatment of major depressive disorder, dysthymia (a chronic, less severe form of depression), and subsyndromal depression (an acute mood disorder that is less severe than major depression). Overall, current evidence on the drugs is insufficient for clinicians to predict which medications will work best for individual patients.
The new analysis was completed by the AHRQ's RTI International-University of North Carolina Evidence-based Practice Center. Select to access our press release and review the report.
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2. Increased Use of Prescription Medicines Changing Health Care Spending Patterns
The 1 percent of Americans who spend the most on medical care experienced a drop in their share of the Nation's overall health care spending from 28 percent to 24 percent between 1996 and 2003, according to a new AHRQ study. In general, the concentration of health care spending in the United States has shifted partly because of rapid growth in prescription drug spending and slower growth in spending for hospital care. Between 1996 and 2003, inflation-adjusted spending on prescription medicines increased by 125 percent, while spending for hospital care grew by only 11 percent. As a result, spending for prescription medicine accounted for 20 percent of overall medical care expenditures in 2003, up from 12 percent in 1996. During the same period, the share of spending for hospital care dropped from 39 percent to 34 percent.
The study, “Prescription Drugs and the Changing Concentration of Health care Expenditures,” led by AHRQ researchers Samuel H. Zuvekas, Ph.D., and Joel W. Cohen, Ph.D., was published in the January-February issue of Health Affairs. Select to read the abstract in PubMed®. A reprint copy is available by sending an E-mail to ahrqpubs@ahrq.hhs.gov.
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3. AHRQ Resources for Pandemic Flu Available
To help communities prepare for a flu pandemic and other emergencies, AHRQ is making available several tools from its Bioterrorism and Emergency Preparedness program. Many of AHRQ's emergency preparedness resources can serve as invaluable tools for State and regional planners charged with developing contingency plans for a pandemic flu outbreak.
AHRQ's research is critical to HHS efforts to develop programs to combat bioterrorism and other public health emergencies such as pandemic flu. You can view a list of AHRQ's tools for pandemic flu preparedness and link to the tools. Visit AHRQ's Bioterrorism Planning and Response Web site to learn about other emergency preparedness resources.
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4. Highlights From Our Most Recent Monthly Newsletter
Among the key articles in the online issue of Research Activities:
Studies examine factors influencing postoperative complications and functioning among patients undergoing hip fracture repair.
Older patients hospitalized for hip fracture repair surgery can suffer numerous postoperative complications, but they also must become mobile as soon as possible after surgery to improve their functioning. Two AHRQ-funded studies examined these issues. The first study found that one-fifth of hip fracture patients are admitted to the hospital with a major clinical abnormality that can dramatically increase their risk for postoperative complications if not corrected prior to surgery. The second study revealed that delay in getting older hip fracture patients out of bed after surgery is associated with poor functioning and survival. Select to access this article.
Other articles include:
- Older American Indians often have a poorer view of their own health than their doctors.
- Racial differences in religiosity and religious coping styles are linked to use of health care services by low-income older women.
- Clinician communication through multidisciplinary rounds may improve with well-designed information tools.
Select to access these articles and more.
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5. AHRQ Vacancy Announcement Posted
AHRQ has posted a vacancy announcement for a Social Science Analyst in its Center for Delivery, Organization and Markets. Responsibilities include serving as a task order officer for AHRQ's Accelerating Change and Transformation in Organizations and Networks (ACTION) program. Select for more information about this and other AHRQ vacancies at USAJobs.
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6. AHRQ in the Professional Literature
We are providing the following hyperlinks to journal abstracts through PubMed® for your convenience. Unfortunately, some of you may not be able to access the abstracts because of firewalls or specific settings on your individual computer systems. If you are having problems, you should ask your technical support staff for possible remedies.
Perreira KM. Crowd-in: the effect of private health insurance markets on the demand for Medicaid. Health Serv Res 2006 Oct;41(5):1762-81. Select to access the abstract in PubMed®.
Fongwa MN, Cunningham W, Weech-Maldonado R, et al. Comparison of data quality for reports and ratings of ambulatory care by African American and white Medicare managed care enrollees. J Aging Health 2006 Oct;18(5):707-21. Select to access the abstract in PubMed®.
Taylor BJ, Robbins JM, Gold JI, et al. Assessing postoperative pain in neonates: a multicenter observational study. Pediatrics 2006 Oct;118(4):992-1000. Select to access the abstract in PubMed®.
Myers DS, Mishori R, McCann J, et al. Primary care physicians' perceptions of the effect of insurance status on clinical decision making. Ann Fam Med 2006 Sep-Oct;4(5):399-402. Select to access the abstract in PubMed®.
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If you are a new subscriber or would like to reference information in a previous issue, an archive of this newsletter can be found on AHRQ's Web site at http://www.ahrq.gov/news/enewsix.htm.
Contact Information
Please address comments and questions to Nancy Comfort at Nancy.Comfort@ahrq.hhs.gov or (301) 427-1866.
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Current as of January 2007
Internet Citation:
AHRQ Electronic Newsletter. January 26, 2007, Issue No. 219. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/enews/enews219.htm
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