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Prescription Drug Use Varies By State

Kate Traynor

A pharmacy benefit management company (PBM) reports that regional differences exist in the use of prescription drugs.

St. Louis, Mo.-headquartered Express Scripts Inc., using data on prescription drugs obtained by more than 800,000 commercially insured health-plan enrollees, found that New Yorkers had the fewest prescriptions filled and obtained the fewest refills in 2000—8.3 per person, on average. Kentucky residents obtained an average of 12.2 prescriptions per person, the highest amount in the country.

According to the PBM, 67 percent of adults obtained at least one new prescription drug or refill in 2000. Leading the country was Kansas, where 71 percent of adults had one or more prescriptions filled during the year. The percentage was lowest in California, where 58 percent of adults had at least one prescription filled.

In general, adults living in the South and Midwest were the most likely to have a prescription filled or refilled, and adults in the Northwest and West were the least likely to have done so. Children living in the West were the least likely to have had a prescription filled, and children in the Midwest and Western South-Central regions of the country were the most likely.

An examination of prescription records by therapeutic class revealed that residents of southern states obtained the fewest drugs for the treatment of asthma. Between 3.6 and 6.9 percent of all enrollees obtained antiasthma drugs in 2000; the national average was 5.3 percent.

Express Scripts reported wide regional variations in the use of prescription cough, cold, and allergy medications among children. On average, 14.6 percent of children received at least one prescription for such a product. Usage was highest in Louisiana, 26.7 percent, and lowest in Maine, 3.5 percent.

The company also found that an average of 10.7 percent of health-plan enrollees received a prescription for an antidepressant. There was no regional pattern in antidepressant use.

Data for the report were obtained from a random sample of Express Scripts beneficiaries who were covered by the PBM throughout 2002. Prescription data included drugs obtained by mail order or from community pharmacies. A CD-ROM version of the entire report, the "Prescription Drug Atlas," is available from Express Scripts.