Americans May Take Prescription Drugs for Around Half Their Lives

Americans born in 2019 are expected to take prescription medications for roughly half their lives, according to new research examining trends in prescription drug use in the United States. The study, published in Demography, also highlights increases in the proportion of people’s lives they can expect to take five or more drugs as well as differences across racial and ethnic minorities.

Rising trends in use of prescription drugs

The use of prescription drugs is high and continues to rise, a testament to what the study’s author, Dr. Jessica Y. Ho, describes in the paper as the “centrality of prescription drugs in Americans’ lives today.”

In 2020 alone, 6.3 billion prescriptions were dispensed in the US, with a 2015–2016 survey finding that almost half (45.8%) of US adults took prescription drugs in the previous month, rising to 85% of adults over the age of 60 years.

Many factors are likely at play. For example, an aging population, the increasing burden of chronic diseases, the development of new drugs, expanded uses of existing drugs, as well as “medicalization” – society’s expectations for “a pill for every ill.”

But the way we are using drugs is also changing – antibiotics, some of the first drugs developed, require only short-term use. Now, routinely prescribed drugs such as cholesterol-lowering statins, antihypertensives and antidepressants are taken over the course of many years.

“Despite this widespread acceptance, these drugs were only developed within the past fifty years or so, and we’re only now seeing cohorts of older adults who have been on those drugs for decades,” explained Ho, an associate professor of sociology and demography at Penn State University, speaking to Technology Networks.

Nevertheless, few estimates exist for the duration that US adults are taking prescription medications across the life course. Ho’s study therefore produces new estimates and examines concerns surrounding the overutilization of prescription drugs, increasing costs and the potential for negative effects on health.

“While prior studies had produced estimates of what percentages of Americans are taking prescription drugs, there were no existing estimates of how long or how much of their lifetimes Americans could now expect to spend taking prescription drugs. This study aimed to address these gaps in our knowledge,” Ho added.

Producing new estimates

Ho first estimated the life expectancy of Americans born in 2019 using mortality data from the National Center for Health Statistics and the Human Mortality Database. This was combined with survey data detailing prescription drug use in the US – collected from 1996–2019 across approximately 15,000 households – to calculate the percentage of their lifetimes they could be taking prescription medications.

Ho’s analysis suggests that men born in 2019 are expected to take prescription drugs for an average of 36.8 years (48% of their life), and women for 47.5 years (60% of their life). Additionally, women have higher rates of prescription drug use than men at every age. The majority of men are taking prescription drugs by 40 years of age, while the majority of women are taking prescription drugs by 15 years.

Women are more likely to be prescribed hormonal contraceptives, psychotherapeutics (particularly antidepressants), anti-infectives and painkillers. Additionally, women are more likely to seek care. Pain-related chronic conditions (such as migraine, rheumatoid arthritis and fibromyalgia) are more common in women. On the other hand, men were more likely to take drugs for cardiovascular disease such as statins to lower cholesterol.

The number of drugs being taken has also shifted – in 1996, men at any age did not take five or more drugs for over a third of their remaining life expectancy. However, by 2019, men over 50 years could expect to take five or more drugs for 36–53% of their remaining years. For women, the largest percentage of remaining lifespan taking five or more drugs in 1996 was 38%, but by 2019, women over 50 years could expect to take five or more drugs for 40–58% of their remaining years.

“There are also important differences in prescription drug use by race and ethnicity: non-Hispanic Whites take the most, Hispanics take the least and non-Hispanic Blacks fall in between these extremes,” said Ho. “Lower rates of statin use among non-Hispanic black men compared to their non-Hispanic white and Hispanic counterparts is concerning given non-Hispanic black men’s high rates of cardiometabolic disease mortality.”

A focus on the future

“The years that Americans can expect to spend taking prescription drugs are now higher than they might spend in their first marriage, getting an education, or being in the labor force,” said Ho.

“It’s important to recognize the central role that prescription drug use has taken on in our lives. It’s also sobering to see how many drugs people are taking – in the mid-1990s, most people were taking only one prescription drug. Today, they are just as likely to be taking five or more drugs.”

“The estimates are what we call synthetic cohort estimates, which means that these are the years Americans born in 2019 could expect to spend taking prescription drugs if they were subject to the prescription drug use rates and mortality rates that we observe in 2019,” Ho explains, highlighting that, should rates of prescription drug use change, this study population could expect to take these drugs for even larger portions of their lives.

Next, Ho wishes to investigate how the US stacks up on an international scale, comparing this data to that of other high-income countries such as Canada, France, Germany, Japan and the United Kingdom.

Reference: Ho JY. Life course patterns of prescription drug use in the United States. Demography. 2023;60(5):1549-1579. doi: 10.1215/00703370-10965990

Dr. Jessica Y. Ho was speaking to Dr. Sarah Whelan, Science Writer for Technology Networks.