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 Potential for Integrative Care Revealed in MedCo Study of Rising Medication of Kids - Michael Levin 
The following is one in an ongoing series of columns entitled Integrator Blog by . View all columns in series
Summary: A disturbing new report from Medco documents the growing use of major pharmaceuticals in the treatment of children. Use with childhood chronic diseases is highlighted with a particular area of concern the drug treatment of Type 2 diabetes associated with childhood obesity. Integrator columnist Michael Levin, a healthcare consultant with Health Business Strategies, seizes on the report's recommendation that "health plans actively promote lifestyle change." Levin urges the right integrative medicine entrepreneurs to step up to a potentially lucrative business opportunity.

Columnist Michael Levin of Health Business Strategies
The business of integration seems sometimes to revolve around receptor sites. The generalized coolness of conventional coverage and delivery stakeholders toward integrative practices requires finding the optimal strategic niches into which to notch the integrative strategy. 

In this opinion piece, Integrator columnist Michael Michael Levin steers readers to an emerging receptor site for payers revealed in a new report from Medco entitled New Research: Kids' Consumption of Chronic Medications on the Rise. Levin,
founder of Clackamas, Oregon-based Health Business Strategies, suggests that these trends are opening a path for "those equipped and inclined to develop and deploy a wellness intervention program on a shared-risk basis, focused on aggressively down-regulating obesity trends." Levin is available at 503-753-3568


Drug Utilization Trends in Children and Adults:
Opportunities for Integrative Medicine

Michael D. Levin, Health Business Strategies
Clackamas, OR  97015

"One of the more stunning statistics recently released from Medco Health Solutions, Inc. is this:

In 2009, more than one in four insured children in the U.S. and nearly 30% of adolescents (10-19 year olds) took at least one prescription medication to treat a chronic condition.
Medco: Recommends lifestyle programs to shift drug trends in kids
"Wow. Adding the previously uninsured population into these numbers under healthcare insurance reform will drive this spending metric ever northward.

"Type 2 diabetes in juveniles, driven by the childhood obesity epidemic, saw medication  increase by 5.3% in 2009, the largest increase across all age groups and higher than the overall utilization growth of 2.3 percent. The obesity epidemic is also reflected in increase utilization of drugs for hypertension and gastroesophogeal reflux (proton pump inhibitors or PPIs). I'll not comment on long term side effects.

"Then there are ADHD treatments, which accounted for 13.2 percent of drug benefit dollars spent on children in 2009.

"It's the same old bottom line: Rather than addressing the underlying causes, which include diet, exercise, education and correcting disordered nutritional biochemistry, our healthcare system continues to spend it's way into economic oblivion on simply treating symptoms.

"What about drug utilization trends in adults?

 Medco Recommendation:

"Prescription drugs may positively affect
short-term outcomes, but plans should
actively promote lifestyle changes to
influence the long-term outcomes."

"Digging into Medco's 2010 Drug Trend Report, one finds more reminders of our obesity epidemic. Drugs used to treat endocrine and diabetes represented 9.4% of total spend in 2009, with double digit increases in trend and cost per day forecasted for the next two years (at least).

"In Medco's wisdom, they offer these considerations:

  • Plans should actively develop programs for prevention (nutritional counseling), mitigation (diet, exercise), and education on the risks associated with obesity (chronic disease and comorbidities).

  • Prescription drugs may positively affect short-term outcomes, but plans should actively promote lifestyle changes to influence the long-term outcomes.

"These are wise recommendations. And, in my humble opinion, they represent significant business opportunities for those equipped and inclined to develop and deploy a wellness intervention program on a shared-risk basis, focused on aggressively down-regulating obesity trends.

"This is all about influencing behavior change, folks. Use the right carrots and sticks and presto! Behavior will change, health will be improved, costs will be reduced and some folks will rightly earn a great deal of money.

"If these trends are not reversed, I clearly see the future for our children: it is fat, broke and prematurely dead."

Comment: Levin's commentary reminds me of the huge chasm between the kinds of outcomes integrative practitioners claim (e.g. diminished need for drugs amidst "wellness intervention programs" as Levin calls them that focus on habit change) and the kinds of questions that are routinely being asked in the integrative practice research community. It would be nice to have more hard evidence that practitioners do what they claim. Who might respond to a solicitation of proposals that would seek to lower obesity in children? (The bright light in this general area, though not focusing on children, is the May 2010 move of the Centers for Medicare and Medicaid toward coverage of the Dean Ornish's program for reversing atherosclerosis.) Meantime, are there any integrative businesses out there that want to step up to Levin's challenge?

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 About The Author
Resumes are useful in employment decisions. I provide this background so that you may understand what informs the work which you may employ in your own. I have been involved as an organizer-writer in the emerging fields......moreJohn Weeks
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