Potential for Integrative Care Revealed in MedCo Study of Rising Medication of Kids – Michael Levin

Summary: A disturbing new report from Medco documents the growing use of major pharmaceuticals in the treatment of children. Use with childhood chronic diseases is highlighted with a particular area of concern the drug treatment of Type 2 diabetes associated with childhood obesity. Integrator columnist Michael Levin, a healthcare consultant with Health Business Strategies, seizes on the report’s recommendation that “health plans actively promote lifestyle change.” Levin urges the right integrative medicine entrepreneurs to step up to a potentially lucrative business opportunity.

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Columnist Michael Levin of Health Business Strategies

The business of integration seems sometimes to revolve around receptor sites. The generalized coolness of conventional coverage and delivery stakeholders toward integrative practices requires finding the optimal strategic niches into which to notch the integrative strategy. 

In this opinion piece, Integrator columnist Michael Michael Levin steers readers to an emerging receptor site for payers revealed in a new report from Medco entitled New Research: Kids’ Consumption of Chronic Medications on the Rise.
Levin, founder of Clackamas, Oregon-based Health Business Strategies, suggests that these trends are opening a path for “those equipped and
inclined to develop and deploy a wellness intervention program on a
shared-risk
basis, focused on aggressively down-regulating obesity trends.” Levin is available at
503-753-3568



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Drug Utilization
Trends in Children and Adults:
Opportunities for Integrative Medicine


Michael D. Levin, Health Business Strategies

Clackamas, OR  97015





“One of the more stunning statistics recently released from
Medco Health Solutions, Inc.
is this:

In 2009, more than one in four insured
children in the U.S. and nearly 30% of adolescents (10-19 year olds) took at
least one prescription medication to treat a chronic condition
.

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Medco: Recommends lifestyle programs to shift drug trends in kids

“Wow. Adding the
previously uninsured population into these numbers under healthcare insurance
reform will drive this spending metric ever northward.


“Type 2 diabetes in juveniles, driven by the childhood obesity epidemic, saw
medication  increase by 5.3% in 2009, the largest increase across
all age groups and higher than the overall utilization growth of 2.3 percent.
The obesity epidemic is also reflected in increase utilization of drugs for
hypertension and gastroesophogeal reflux (proton pump inhibitors or PPIs). I’ll
not comment on long term side effects.


“Then there are
ADHD treatments, which accounted for 13.2 percent of drug benefit dollars spent
on children in 2009.


“It’s the same
old bottom line: Rather than addressing the underlying causes, which include diet,
exercise, education and correcting disordered nutritional biochemistry, our
healthcare system continues to spend it’s way into economic oblivion on simply
treating symptoms.


“What about drug
utilization trends in adults?

   
 
 Medco Recommendation:

“Prescription drugs may
positively affect
short-term outcomes, but plans should
actively
promote
lifestyle changes to

influence the long-term outcomes.”


“Digging into
Medco’s 2010 Drug Trend Report, one finds more reminders of our obesity epidemic. Drugs used to treat endocrine and diabetes represented 9.4% of total spend in
2009, with double digit increases in trend and cost per day forecasted for the
next two years (at least).


“In Medco’s
wisdom, they offer these considerations:

  • Plans should actively develop
    programs for prevention (nutritional counseling), mitigation (diet, exercise),
    and education on the risks associated with obesity (chronic disease and
    comorbidities).

  • Prescription drugs may
    positively affect short-term outcomes, but plans should actively promote
    lifestyle changes to influence the long-term outcomes.


“These are wise recommendations. And, in my humble opinion,
they represent significant business opportunities for those equipped and
inclined to develop and deploy a wellness intervention program on a shared-risk
basis, focused on aggressively down-regulating obesity trends.

“This is all
about influencing behavior change, folks. Use the right carrots and sticks and
presto! Behavior will change, health will be improved, costs will be reduced
and some folks will rightly earn a great deal of money.


“If these trends are not reversed, I clearly see the
future for our children: it is fat, broke and prematurely dead.”




Comment: Levin’s commentary reminds me of the huge chasm between the kinds of outcomes integrative practitioners claim (e.g. diminished need for drugs amidst “wellness intervention programs” as Levin calls them that focus on habit change) and the kinds of questions that are routinely being asked in the integrative practice research community. It would be nice to have more hard evidence that practitioners do what they claim. Who might respond to a solicitation of proposals that would seek to lower obesity in children? (The bright light in this general area, though not focusing on children, is the May 2010 move of the Centers for Medicare and Medicaid toward coverage of the Dean Ornish’s program for reversing atherosclerosis.) Meantime, are there any integrative businesses out there that want to step up to Levin’s challenge?

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John Weeks Written by John Weeks

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