Health Affairs has a new study on the web that confirms the blindingly obvious. People with better insurance coverage will use more health services than those without insurance. What’s interesting about this study is that it looked at the difference by comparing those with drug coverage to those without in Cox-2 Inhibitor use (that’s Celebrex and Vioxx to you) in the Medicare population.
As you may know Cox-2s are painkillers that are supposed to kill pain without the adverse side effects to the GI tract that some 35% of the population gets from NSAIDs and ibuprofen. But they don’t do more to end pain and they cost a whole lot more than NSAIDS, so theoretically the health care spending wonks think that their use should be limited to those patients with demonstrated GI problems from using alternatives. But of course real life isn’t like that, and as a study from Express Scripts showed last year, patients are getting prescribed Cox-2 inhibitors whether or not they have GI problems. There’s also been contention that Celebrex isn’t as safe for the GI as it’s been made out to be, but that’s another story.
The new study shows that although GI problems are a pretty good predictor of increased COX-2 use among the senior population, good drug insurance coverage is twice as good a predictor. And then, noting that even more seniors are going to be getting a drug benefit soon, in my favorite part the authors conclude in academic-ese:
Our study suggests that policymakers should be concerned with potential overuse of drug therapy by Medicare beneficiaries once the benefit is implemented.
All together now, "Duh!". That’s what the legislation was supposed to create, although the authors might find that they and PhRMA have a different definition of the word "overuse"!