From
Forbes.com:
You probably never stopped to think if where you live has anything to do with the number of prescription medications you're taking. But if you live in the American South, chances are you take more medications than you would if you lived on the other side of the Mason-Dixon Line.
In fact, when it comes to residents popping the largest numbers of pills, Southern states beat the average by a long shot. States filled an average 11.1 retail prescriptions per capita in 2006, according to the latest figures compiled by the non-profit Kaiser Family Foundation's statehealthfacts.org and Vector One: National, data provider Verispan's national-level prescription and patient tracking service.
Well above that average is West Virginia, which came in first with 17.2 retail prescriptions filled per capita, followed by Missouri, 15.9; Tennessee, 15.8; Alabama, 15.7; and Kentucky, 15.4.
At the bottom of the list were Alaska, 6.5; California, 7.4; and Hawaii, 7.7.
Behind The Numbers
Verispan collected the 2006 data from a panel of retail pharmacies (including independent and chain pharmacies, food stores and mass merchandisers found in more than 800 regional zones), third-party payers and other data providers. Prescriptions may have been new or refills of both brand name and generic drugs. The numbers exclude mail-order purchases, which have been reported to make up just under 7% of total prescriptions filled in 2006.
While it may seem strange that states and regions have such disparities in terms of their residents' use of prescription drugs, other research bears out similar findings. Studies in 2000 and 2006, conducted by pharmacy benefit manager Express Scripts on millions of patients enrolled in a commercial plan show that Kentucky and Louisiana were among the top five states in both years with the highest overall prevalence of seven major drug therapy classes, including
anti-hyperlipidemics (drugs that lower lipid levels in the blood),
anti-diabetics,
anti-hypertensives,
gastrointestinal medications,
antidepressants,
analgesics /
anti-inflamatories and
estrogen.
West Virginia, Tennessee, Alabama and Mississippi also commonly appeared among the top five states with the highest usages of these types of drugs in 2006.
A Weighty Matter
So why is use of prescription drugs highest in the South? Experts say a major reason is high obesity rates in the region. About 32.6% of adults in Mississippi were considered obese in 2007, according to the latest statistics from the Centers for Disease Control and Prevention (CDC). Alabama, Louisiana, Tennessee and West Virginia rounded out the top five heavyweights, all registering rates over 30%.
"Obesity is just a known risk factor for chronic conditions, such as diabetes and hypertension," says Emily Cox, senior director of research for Express Scripts. "If you have one of those conditions, the primary mode of care in many cases is going to be drug therapy."
The Unknowns
And then there are differences that are harder to quantify. The penetration of health plans and the prescription drugs they cover in a particular state may affect what's being prescribed, says Mitch Rothholz, chief of staff of the American Pharmacists Association.
Likewise, certain states may have more health screenings than others or a greater number of doctors who initiate drug treatment early, Cox adds. Some physicians also may have a greater propensity to prescribe drug treatment than their counterparts across the country. That may be influenced by doctors' training, peers, literature they read and their experiences in prescribing particular drug treatments as well as patients' preferences.