Antidepressants Help Fuel Record Rise in Drug Benefits’ Costs

Americans’ growing use of antidepressants such as Prozac helped lead to the largest-ever rise in the cost of drug benefits last year, according to data released Tuesday by the largest manager of pharmacy benefits plans.

The use of drugs such as Prozac, Zoloft and Paxil increased 12% in 1998, and the use of high-blood-pressure drugs rose 10%, said Barrett Toan, chief executive of Express Scripts Inc. of St. Louis, which manages pharmacy benefit plans with 47 million members.

Drug usage to control diabetes, lower cholesterol, treat digestive problems and open sinuses also rose.

Last year’s annual per-member cost on an average wholesale price basis before co-payments, discounts and active management of drug costs was $329.48, up about 17% from $282.48 in 1997.

That cost increase was the largest reported by Express Scripts since 1993, when the company began monitoring drug cost and utilization trends. Another increase of more than 16% is anticipated this year, with rises between 13% and 17% expected in each of the next five years.

The cost of drugs is a hot topic these days as President Clinton tries to overhaul Medicare and include drug coverage for all beneficiaries. Currently, consumers without a pharmacy benefits plan can rack up hundreds of dollars in medication costs each month.

Express Scripts released the 1998 Drug Trend Report at a national conference of employers, managed-care organizations and other pharmacy benefit plan sponsors. It was based on a large sample of 8.8 million people last year.

Not only did the use of antidepressants rise but so did their cost. By next year the category will be “the single-most expensive drug class there is,” Toan said.

In fact, in the 1997-98 period, costs of all but one of the nation’s 50 most prescribed drugs rose--many several times and often by double digits.