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LEADING ARTICLE
Drugs Aging 2003; 20 (4): 253-261 1170-229X/03/0004-0253/$30.00/0 © Adis International Limited. All rights reserved.
Cost of Pharmacological Care of the Elderly Implications for Healthcare Resources Ciaran O’Neill,1 Carmel M. Hughes,2 James Jamison3 and Anna Schweizer2 1 School of Policy Studies, University of Ulster Jordanstown, Newtownabbey, Northern Ireland, UK 2 School of Pharmacy, Clinical and Practice Research Group, Queen’s University Belfast, Belfast, Northern Ireland, UK 3 Centre for Social Research, Queen’s University Belfast, Belfast, Northern Ireland, UK
Abstract
Expenditures on prescribed medicines are significantly higher among those aged 65 years and over than among younger people. As populations in developed countries age so the cost of pharmacological care associated with the older population can be expected to increase. While pharmacological care represents only one component of healthcare, its costs are increasing rapidly because of advances in technology and increasing use. However, such costs should be considered within a context of decreasing disability in the elderly population, improving economic conditions among seniors and the relationship of these costs with those in other aspects of healthcare. Where medications have been demonstrated to be cost-effective, attempts to curtail expenditure growth may prove a false economy resulting in significantly higher growth elsewhere such as in the hospital and long-term care sectors. Policy responses to this issue should encompass the inclusion of elderly patients in clinical trials, the use of evidence-based principles of practice and strategies to ensure that this population obtain maximum benefit from medication through education and counselling.
Population aging (conventionally described as increases in the percentage of the population aged 65 years and over) is likely to be a source of increasing concern to healthcare planners in developed economies over at least the next 20 years. Particular issues relate to the capacity of the healthcare system to meet growing demands for services and where funding for those services can be found. As the population ages, so too will demand for services. As increasing numbers retire, personal incomes as well as the numbers from whom income taxes can be raised (both important sources of
funding) will fall. These points are illustrated in table I, where the increase in the number of seniors, their disproportionate consumption of healthcare resources and diminishing incomes are clearly apparent. Concerns also exist regarding the impetus within healthcare systems to further fuel demand. For example, as the number of those over 65 years increases, the effort expended by innovators in expanding the market for healthcare technologies used by seniors may increase. That is, aging could result in innovators and advertisers targeting this age group more heavily than is already the case in
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Table I. Health consumption, earnings and changes in population structure in selected countries Country
Percentage of the population aged ≥65 years in 2000[3]
Percentage of the population aged ≥65 years in 2020 (projected)[3]
Ratio of health spending for persons aged ≥65 years to those aged
