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Medco Health Solutions, Inc. Release: New Data: Antipsychotic Drug Use Growing Fastest Among Children

5/2/2006 11:32:16 AM

FRANKLIN LAKES, N.J., May 2 /PRNewswire-FirstCall/ -- Children are the fastest growing category of users of antipsychotic drugs, according to an analysis by Medco Health Solutions, Inc. , a leading pharmacy benefit manager. While still a relatively low patient population, the number of children ages 19 and younger using antipsychotic medicines rose 73 percent from 2001 to 2005, far outpacing the 37 percent increase among 20- to 44-year- olds.

While the use of atypical antipsychotic drugs in children is not approved by the Food and Drug Administration (FDA), Medco's analysis of over 2 million insured Americans found that the number of children taking these medications has risen continuously over the past 4 years. This differs from trends seen in utilization of other behavioral medications including ADHD medications -- where use among children remained flat from 2004 to 2005 and antidepressants -- which saw a significant drop in use among children in that one-year period.

Children are receiving the latest generation of antipsychotics - known as atypical antipsychotics, including risperidone, olanzapine, clozapine, ziprasidone and quetiapine - at a much higher rate than adults. Of the patients prescribed antipsychotics, children received the newer atypical drugs 97 percent of the time rather than the older treatments. Adults received the newer antipsychotics 88 percent of the time. These drugs have been used as treatments for bipolar disorder, conduct disorder, ADHD, depression, Tourette's syndrome and other conditions.

"Children are receiving antipsychotics with greater frequency and that may be because they are viewed as less dangerous than the older medications and can be helpful for conditions that were previously treated with other medications," said Medco's chief medical officer, Dr. Robert Epstein. "However, these drugs are not without their risks. There is evidence that the risk of diabetes and metabolic disorders from using atypical antipsychotics could be much more severe for pediatric patients than adults, and there is a need for more studies to understand the long-term effects of these drugs on children."

Further findings from the analysis show that the growth in use among girls has been far greater than in boys. The number of girls under 20 on antipsychotics grew 103 percent from 2001 to 2005, as compared to boys whose use increased by 61 percent. During this same time period, there was a 15 percent increase in women 20 and over taking these medications, and a 9 percent hike for men of this age group.

While growth in use has been dramatic among children, adults still take these medications at a 69 percent higher rate than children. In 2005, nearly 7 children (0-19) out of one thousand were taking an antipsychotic, compared with 11 per 1000 adults. Among senior citizens 65 and older, the prevalence of antipsychotic use is three times that of children, at 21 per 1000.

Addressing pediatric antipsychotic use

There are a number of plan management programs that Medco offers its clients looking to address the cost and safety of these drugs and prevent unnecessary use of antipsychotics. Per member antipsychotic drug costs for children 19 and under have increased 196 percent, or nearly triple 2001's total. Much of this can be attributed to the increased use of atypical drugs, which are not yet available in generic form, as well as increased prevalence. Prior authorization and step therapy programs can help health plan sponsors control overall drug spending. Medco's drug utilization review programs and its RationalMed(R) Patient Safety System also monitor poly pharmacy, dosing and drug interaction issues for these medications, especially in patients with cardiac, metabolic and neurological conditions, such as hypertension, diabetes, and seizures.

"Doctors need to be judicious when prescribing antipsychotic drugs to children," Epstein said. "The use of these drugs can have the pediatric patient trading a behavioral condition for a lifelong metabolic condition that can lead to significant health complications."

About Medco

Medco Health Solutions, Inc. is a leader in managing prescription drug benefit programs that are designed to drive down the cost of pharmacy health care for private and public employers, health plans, labor unions and government agencies of all sizes, and for individuals served by the Medicare Part D Prescription Drug Program. Medco's technologically advanced mail-order pharmacies and award-winning Internet pharmacy have been recognized for setting new industry benchmarks for pharmacy dispensing quality. Medco serves the needs of patients with complex conditions requiring sophisticated treatment through its specialty pharmacy operation, which became the nation's largest with the 2005 acquisition of Accredo Health, Incorporated. Medco is the highest-ranked pharmacy benefit manager on the 2006 Fortune 500 list, reporting revenues of nearly $38 billion in 2005. On the Net:

This press release contains "forward-looking statements" as that term is defined in the Private Securities Litigation Reform Act of 1995. These statements involve risks and uncertainties that may cause results to differ materially from those set forth in the statements. No forward-looking statement can be guaranteed, and actual results may differ materially from those projected. We undertake no obligation to publicly update any forward- looking statement, whether as a result of new information, future events, or otherwise. Forward-looking statements in this press release should be evaluated together with the risks and uncertainties that affect our business, particularly those mentioned in the Risk Factors section of the Company's Annual Report on Form 10-K filed with the Securities and Exchange Commission.

Medco Health Solutions, Inc.

CONTACT: Jennifer Leone, Medco Health Solutions, Inc., +1-201-269-6402,; or Janet Schiller or Bill Borden, Coyne PublicRelations, +1-973-316-1665, for Medco

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