Overmedication: Health Risks and Rocketing Costs

The use of multiple medicines, known as polypharmacy, is a growing public health threat across the globe, leading to unnecessary harm, reduced quality of life, and significant healthcare costs.

In an article, the Annual Review of Pharmacology and Toxicology reported that up to 50% of patients who take four or more medications, many of whom are elderly, don’t take them as prescribed, leading to ineffectiveness or increased risk of harm. Drug interactions can occur, and elderly people face greater risk of severe side effects as their liver is less efficient at metabolizing. 

According to the World Health Organization, polypharmacy contributes to millions of hospitalizations and unnecessary health expense. And with the “greying” population on the rise, the problem of overmedication is predicted to grow. In the US, the older-adult population is expected to increase by 81% from 2018 to 2060, predicts the US Department of Health and Human Services.  

The nonprofit Lown Institute estimates that 42% of older adults in the US take five or more prescription medications a day, while 20% take 10 or more a day. Polypharmacy, the institute says, has tripled in the last two decades.

Experts believe at the root of the problem is the for-profit model of the pharmaceutical industry, which often pays doctors to prescribe drugs. In 2019 ProPublica reported that doctors who received payments from drug manufacturers prescribed that drug more often than doctors who didn’t accept or receive payments. Further, specialists may prescribe medications without an overall picture of a patient’s treatment and health. 

According to the Lown Institute, blood thinners, diabetes medications, and opioids are the most likely to cause adverse drug reactions that result in an emergency room visit.  Medications that have the greatest potential for harmful side effects, reports Lown, are sedative hypnotics such as anti-depressants and sleep medications, over-the-counter drugs, blood pressure medication, and antipsychotic drugs.

In the US, some efforts are underway to address the problem of polypharmacy.  Close to 2,000 healthcare organizations have joined the Age-Friendly Health Systems initiative to follow guidelines for care of the elderly. These include avoiding high-risk medications, deprescribing if needed, and establishing a safe-dose medication plan.