America: The land of the medicated?

updated 5:41 p.m. ET April 18, 2005

PLYMOUTH, Mass. - Alice and Ken Heckman each begin their morning by cracking open a rattling plastic tray carting scores of pills in a rainbow of pastel colors.

Between the two of them, they gulp 29 pills every day: a regimen of 14 drugs, with a chaser of dietary supplements.

Here’s the curious part: They feel pretty hale for people in their early 70s, working around the house and volunteering with several community groups. They each had heart fixes years ago — him a bypass and her a vessel-clearing stent — but fully recovered. She has well-controlled diabetes. He has worked his way through heartburn, arthritis, an enlarged prostate and occasional mild depression.

About 130 million Americans — many far healthier than the Heckmans — swallow, inject, inhale, infuse, spray, and pat on prescribed medication every month, the U.S. Centers for Disease Control and Prevention indicates. Americans buy much more medicine per person than any other country.

3.5 billion prescriptions per year
The number of prescriptions has swelled by two-thirds over the past decade to 3.5 billion yearly, according to IMS Health, a pharmaceutical consulting company. Americans devour even more nonprescription drugs, polling suggests.

Recently, safety questions have beset some depression and anti-inflammatory drugs, pushing pain relievers Vioxx and — most recently — Bextra from the market. Rising ranks of doctors, researchers and public health experts are saying that America is overmedicating itself. It is buying and taking far too much medicine, too readily and carelessly, for its own health and wealth, they say.

Well over 125,000 Americans die from drug reactions and mistakes each year, according to Associated Press projections from landmark medical studies of the 1990s. That could make pharmaceuticals the fourth-leading national cause of death after heart disease, cancer and stroke.

The pharmaceutical industry served up more than $250 billion worth of sales last year, the vast majority in prescriptions, according to industry consultants. That roughly equaled sales at all the country’s gasoline stations put together, or an $850 pharmaceutical fill-up for every American.

Do we need all these drugs?
Do we need all these drugs? A relative handful yank many people away from almost certain death, like some antibiotics and AIDS medicines. Though carrying some risk, other drugs — such as cholesterol-cutting statins — help a considerable minority dodge potential calamities like heart attack or stroke.

The right balance of risk and benefit is still harder to strike for a raft of heavily promoted drugs that treat common, persistent, daily life conditions: like anti-inflammatories, antacids, and pills for allergy, depression, shyness, premenstrual crankiness, waning sexual powers, impulsiveness in children — you name it.

“We are taking way too many drugs for dubious or exaggerated ailments,” says Dr. Marcia Angell, former editor of the New England Journal of Medicine and author of “The Truth About the Drug Companies.”

“What the drug companies are doing now is promoting drugs for long-term use to essentially healthy people. Why? Because it’s the biggest market.”

In fact, relatively few pharmaceutical newcomers greatly improve the health of patients over older drugs or advance the march of medicine. Last year, the U.S. Food and Drug Administration classified about three-quarters of newly approved drugs as similar to existing ones.

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