Life Course Patterns of Prescription Drug Use in the United States

Abstract

Prescription drug use has reached historic highs in the United States-a trend linked to increases in medicalization, institutional factors relating to the health care and pharmaceutical industries, and population aging and growing burdens of chronic disease. Despite the high and rising prevalence of use, no estimates exist of the total number of years Americans can expect to spend taking prescription drugs over their lifetimes. This study provides the first estimates of life course patterns of prescription drug use using data from the 1996-2019 Medical Expenditure Panel Surveys, the Human Mortality Database, and the National Center for Health Statistics. Newborns in 2019 could be expected to take prescription drugs for roughly half their lives: 47.54 years for women and 36.84 years for men. The number of years individuals can expect to take five or more drugs increased substantially. Americans also experienced particularly dramatic increases in years spent taking statins, antihypertensives, and antidepressants. 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. Americans are taking drugs over a wide and expanding swathe of the life course, a testament to the centrality of prescription drugs in Americans' lives today.

Keywords: Demography; Health care; Life course; Prescription drugs.

Fig. 1

Percentage of Americans taking (a) any prescription drugs by age and sex and (b) key prescription drugs by age, sex, race, and ethnicity in 2019. The key prescription drugs are antineoplastics, biologicals and immunologic agents, cardiovascular agents, CNS agents, coagulation modifiers, gastrointestinal agents, genitourinary tract agents, hormones and hormone modifiers, respiratory agents, psychotherapeutic agents, and metabolic agents. The dashed horizontal line indicates the point at which more than 50% of the population in that age group is taking prescription drugs. Source: Author’s analysis of data from the MEPS, 2019.

Fig. 2

Age-standardized percentage of U.S. men and women taking zero, one, two, three, four, and five or more key prescription drugs (a) for the total population in 1996–2019 and (b) by race and ethnicity in 2006–2019. The key prescription drugs are antineoplastics, biologicals and immunologic agents, cardiovascular agents, CNS agents, coagulation modifiers, gastrointestinal agents, genitourinary tract agents, hormones and hormone modifiers, respiratory agents, psychotherapeutic agents, and metabolic agents. Source: Author’s analysis of data from the MEPS, 1996–2019.

Fig. 2

Age-standardized percentage of U.S. men and women taking zero, one, two, three, four, and five or more key prescription drugs (a) for the total population in 1996–2019 and (b) by race and ethnicity in 2006–2019. The key prescription drugs are antineoplastics, biologicals and immunologic agents, cardiovascular agents, CNS agents, coagulation modifiers, gastrointestinal agents, genitourinary tract agents, hormones and hormone modifiers, respiratory agents, psychotherapeutic agents, and metabolic agents. Source: Author’s analysis of data from the MEPS, 1996–2019.

Fig. 3

Expected years taking zero, one, two, three, four, and five or more key prescription drugs at selected ages by sex for the total population in 1996 and 2019. The key prescription drugs are antineoplastics, biologicals and immunologic agents, cardiovascular agents, CNS agents, coagulation modifiers, gastrointestinal agents, genitourinary tract agents, hormones and hormone modifiers, respiratory agents, psychotherapeutic agents, and metabolic agents. Source: Author’s analysis of data from the MEPS and the HMD, 1996 and 2019.

Fig. 4

Expected years spent taking common classes of prescription drugs at age 0 by sex (a) for the total population between 1996 and 2019 and (b) by race and ethnicity between 2006 and 2019. Source: Author’s analysis of data from the MEPS, the HMD, and the NCHS, 1996–2019.

Fig. 5

Share of remaining life expectancy spent taking specific classes of prescription drugs at ages 0 and 65 for men and women in 1996 and 2019. Source: Author’s analysis of data from the MEPS and the HMD, 1996 and 2019.