We Now Spend More to Fight Aging Than to Fight Disease

Critics of the way Americans grow older have long bemoaned what they call the "medicalization of aging," a perceived societal shift toward treating the natural effects of aging as if they were diseases.

A new study highlights that trend. According to data presented by pharmacy benefit management service Express Scripts at the recent annual meeting of the American Public Health Association in San Francisco, consumers with private insurance now spend, on average, more on prescriptions to fight conditions long seen as natural effects of growing older — including mental alertness, sexual dysfunction, menopause, aging skin and hair loss — than they do on medication to treat chronic disease.

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"At a time when people are forgoing care due to rising health costs, this study reveals a growing trend on where the public is placing its health care dollars," the study’s lead researcher, Dr. Reethi Iyengar of Express Scripts, said in a statement.

Where Our Prescription Dollars Go

As a class of drugs, anti-aging medications trail only diabetes and cholesterol prescriptions in terms of average annual cost per consumer, according to the study, which covered only people who were commercially insured and did not include spending on over-the-counter drugs. Each person spent about $73.30 a year on anti-aging drugs in 2011, a 46 percent increase from 2006. (Many of these drugs may cost consumers more because they are not yet offered as generics or because insurance coverage for such prescriptions varies from plan to plan.) By comparison, consumers spent about $81.12 on diabetes medication in 2011 and $78.38 on prescriptions to control high cholesterol. Medication to treat high blood pressure and heart disease each cost about $63 a year.

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More Medicare recipients are purchasing anti-aging drugs as well. From 2007 to 2011, the number of Medicare recipients receiving such prescriptions rose 32 percent. (The largest share of that increase, 13 percent, took place from 2010 to 2011.) During the same four-year period, the number of privately insured adults ordering anti-aging drugs rose 18.5 percent. Given the number of baby boomers turning 65 every day — an estimated 10,000 — these numbers are sure to rise, potentially putting additional strain on the Medicare system.

'Normal Aging' May Not Be Normal at All

The study does highlight a major shift in prescription spending toward a relatively new class of anti-aging drugs. But the volume of prescriptions being signed by doctors also reflects a growing sense among physicians that conditions long seen as part of normal aging may not be normal at all and merit treatment. The question some critics ask, though, is whether pharmaceutical therapy is most appropriate.

For example, many researchers now believe that erectile dysfunction, or ED, may not be a normal part of aging, but is instead caused by a range of underlying concerns, like psychological conditions, cardiovascular disease, diabetes, thyroid disease, an enlarged prostate and the side effects of certain prescription drugs. Other factors may include the byproducts of lifestyle choices, from consuming too much caffeine or alcohol to smoking, obesity or becoming more sedentary. Even though ED may not be a "normal" part of aging, the best remedy isn't necessarily Viagra, but may instead be lifestyle change or treatment of an underlying cause.

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Margaret Morganroth Gullette, resident scholar at the Women’s Studies Research Center at Brandeis University, and the author of Agewise: Fighting the New Ageism in America, recently wrote on Next Avenue that the United States has been inundated by pharmaceutical marketing. As a result, she said, it has become "a culture that sees aging-past-youth as little but a set of diseases" in which "anti-aging flacks exaggerate the state of their scientific knowledge and play on our dreams of permanent avoidance of old age."

And so, she notes, "more useless, more dangerous choices become available every day to those of us who don’t read the fine print." In addition, too many older adults ignore "established medical sense to chase the preposterous goal of remodeling ourselves to compete with younger people who will, after all, age past youth soon enough in their turn."

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The anti-aging industry is an $80 billion-a-year business, Colin Milner, founder and chief executive officer of the International Council on Active Aging, wrote on Next Avenue. But, as he pointed out, no medication can properly be called "anti-aging," because, as the federal government's National Institute on Aging has stated, "no treatments have been proven to slow or reverse the aging process."

His advice? Before seeking anti-aging prescriptions, "understand that you can obtain the energy you need to feel more youthful by getting more sleep, eating a balanced diet and exercising regularly." Also remember that "everyone grows older from the moment they’re born," he says. "It behooves us to embrace the inevitability of this natural process and the many benefits that can come with it."