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.

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,

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.

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."