Over the 10-year period from 1997 to 2006, prescription claims increased dramatically for older adults in Ontario: from a total of 13,794,276 claims in 1997 to a total of 43,348,670 claims in 2006. This represents a 214% increase over the study period, which far exceeds the growth in the population of Ontario adults aged 65+ during this time period: from 1,384,739 in 1997 to 1,641,454 in 2006, an increase of 18.5%.
Table shows the relative ranking of prescription classes in both 1997 and 2006 and the percentage change in rank order according to percentage increase over the study period. In both 1997 and 2006, cardiovascular medications were the most commonly prescribed medications, followed by psychotropic and gastrointestinal medications. All medication classes increased over the 10-year period, with several of the medication classes increasing by more than 200%. The lowest increases were for primarily symptom-based therapies (non-steroidal anti-inflammatory medications, antibiotics, asthma/chronic obstructive pulmonary disease therapies, and corticosteroids.) The steepest increases were for primarily preventive therapies: medications to prevent osteoporosis increased 2,347%, and lipid-lowering agents used to prevent cardiovascular disease increased 697%. Preventive medications and medications for chronic disease management have increased as a relative percentage of claims, while more primarily symptom-based medications such as analgesics, antibiotics, NSAIDS, COPD medications, and gastrointestinal medications have declined.
Prescription claims by medication class for primary care patients aged 65+ in Ontario, Canada
Also presented in Table are the per person prescription claim rates for each of the unique classes of medication. (Compared to crude claims data, the use of 'claims per person' is advantageous as this measure controls for any change in the population of interest during the study period.) All classes of medication showed an increase in average annual claims per person. For example, for cardiovascular agents, in 1997 the average claims per person was 3.2544, whereas in 2006 the average claims per person was 9.4776, which represents an increase of 191%.
Figure presents the distribution of the number of unique classes of medications prescribed to older adults in Ontario. Data is presented for the years 1997 and 2006. Over this 10-year period, the proportion of older adults making no prescription claims decreased by 36%, and the proportion of older adults taking one to three classes of medications decreased by 17%. Conversely, the proportion of older adults on four to nine classes of medication increased by 34%. Over the same time period, the proportion of older adults who were prescribed 10 or more classes of medication increased by 188%.
Frequency distribution of number of unique medication classes for older adults aged 65+ in Ontario, Canada, 1997-2006.
Figure presents the number of prescription claims per person by gender. As illustrated, claims per person were higher among females than males. In 1997, the overall prescription claims rate for Ontarians aged 65+ was 10 claims per person (female = 11; male = 8); by 2006, the overall claims rate increased to 26 claims per person (female = 31; male = 20).
Gender differences in prescription claims per person for older adults aged 65+ in Ontario, Canada, 1997-2006.
Figure presents the number of prescription claims per person by age group for females and males, respectively. For the 10-year study period, there was an annual increase in the number of claims per person for both sexes. The rate of increase in the number of claims per person was greater for females than for males. This is true for all age groups: in the 65-74 age group, claims per person increased 107% for females and 101% for males; in the 75-84 age group, claims per person increased 170% for females and 132% for males; and, finally, in the 85+ age group, claims per person increased 286% for females and 210% for males.
Age differences in prescription claims per person for older adults aged 65+ in Ontario, Canada, 1997-2006.