Metabolic Syndrome - The Next Epidemic
May 8, 2005 - 12:09:00 PM
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"Metabolic syndrome, and its components -- diabetes and pre-diabetes, obesity, hypertension, and abnormal lipids -- will likely become the major public health problems we face in the 21st century. Its long-term consequences, including heart disease, stroke, and the other complications of diabetes, can be reduced with aggressive treatment of risk factors, but at a substantial cost. Lifestyle approaches should also decrease metabolic syndrome and its long-term health and economic costs."
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By Medco Health Solutions, Inc,
[RxPG] Individually, hypertension, diabetes, and obesity are taking a toll on Americans' health. But according to a new analysis, the prevalence of metabolic syndrome -- a condition characterized by a combination of these and/or other risk factors -- is rapidly becoming one of the nation's costliest health concerns.
Data released by Medco Health Solutions, Inc. (NYSE: MHS - News), shows that the average yearly pharmacy cost of treating adult patients over age 20 with metabolic syndrome exceeds $4,000 -- more than four times the average annual drug spend for all other patients. The analysis also found that the number of adults being treated for the conditions associated with metabolic syndrome increased more than 36 percent from 2002 to 2004.
"Metabolic syndrome, and its components -- diabetes and pre-diabetes, obesity, hypertension, and abnormal lipids -- will likely become the major public health problems we face in the 21st century," said Dr. David M. Nathan, professor of medicine at Harvard Medical School and director of the Diabetes Center at Massachusetts General Hospital. "Its long-term consequences, including heart disease, stroke, and the other complications of diabetes, can be reduced with aggressive treatment of risk factors, but at a substantial cost. Lifestyle approaches should also decrease metabolic syndrome and its long-term health and economic costs."
Patients with metabolic syndrome have three or more risk factors, which include excessive abdominal fat, hypertension, low amounts of "good" cholesterol (HDL), elevated triglyceride levels, and abnormal blood sugar, and are at a 3.5 times greater risk of death from coronary heart disease, as well as an increased risk of liver and kidney disease, and possibly cancer. Metabolic syndrome is closely associated with a generalized metabolic disorder in which the body is unable to use insulin efficiently. Although some people are genetically disposed, others can develop the syndrome due to excess body fat and physical inactivity.
Non-drug treatments for metabolic syndrome include weight loss, dietary changes and increased physical activity. One recently published study from the University of Pittsburgh found that a program involving weight loss and exercise decreased the incidence of metabolic syndrome by almost 41 percent as compared to the control group, while the incidence rate among patients on drug therapy was reduced by only 17 percent.
Dr. Roger Blumenthal, director of the Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, emphasizes the importance of improving lifestyle habits. "The cornerstones of treatment for metabolic syndrome and the prevention of diabetes are better dietary and exercise habits."
Medco's analysis reviewed prescription drug data for approximately 2 million adult patients aged 20 years or older. Those categorized with metabolic syndrome were taking medications for at least three of the risk factors associated with the syndrome -- diabetes, abnormal cholesterol and hypertension. Due to the low prevalence of people on weight loss prescription medications, obesity was not calculated into the cost of metabolic syndrome, but it is a major contributor to the prevalence of this condition.
Among the major findings of the analysis:
-- The greatest growth in the prevalence of metabolic syndrome (2002-2004)was among people between 20 and 44 years old - reflecting a 49 percent increase
-- There was a 20 percent jump (2002-2004) in the number of patients with two risk factors for metabolic syndrome - a population that may be on the cusp of developing the condition
-- Taken together, patients with metabolic syndrome and those at risk accounted for $4 out of every $10 spent on prescription medications for adults
Working with Physicians to Identify Risk
In response to the growing prevalence of metabolic syndrome, and the costs associated with the condition, Medco announced that it will launch the nation's first physician alert system that will use integrated claims data to identify those patients that have, or are at risk of developing, metabolic syndrome. Using Medco's RationalMed® Patient Safety Solutions, enhanced clinical rules will cross-reference pharmacy claims data with laboratory and medical claims data to identify these patients. Once identified, an alert package will be sent to the prescribing physician and the patient providing them with information and recommendations for changes in therapy and/or lifestyle.
Currently, approximately 50 percent of the physicians who receive an alert package generated by RationalMed® make an immediate change in the patient's therapy.
Dr. Robert Epstein, Medco's chief medical officer, says that according to Medco data, metabolic syndrome patients are, on average, prescribed medications by five different physicians and 25 percent are seeing seven different prescribing doctors. He added that these physicians might not always be aware of the myriad of conditions affecting the patient. "Our prescription data allows us to track patients using medications for two or more of the metabolic syndrome risk factors, identifying them as either at risk for, or afflicted with metabolic syndrome -- information that can assist physicians in making the most appropriate treatment choices for their patients."
Metabolic Syndrome - The Next Epidemic
According to medical literature, metabolic syndrome affects nearly 50 million Americans - almost one in four American adults. Approximately 7 percent of adults in their 20s and about 40 percent of adults over age 40 meet the criteria for the syndrome. The prevalence in Americans over age 40 has increased by more than 60 percent in the past decade.
Although no clinical guidelines for the treatment of metabolic syndrome in children currently exist, the prevalence of this condition in children is on the rise. One out of eight children, ages 8 to 17, has been identified as having metabolic syndrome, placing them at greater risk for premature heart disease and diabetes. The most common risk factors among this age group are abnormal cholesterol levels and excessive weight; 32 percent of overweight children develop metabolic syndrome. Adolescent boys are more likely to become afflicted with the syndrome than adolescent girls.
More aggressive treatment of metabolic syndrome could dramatically increase the utilization of medications to treat the underlying conditions, and this growth could accelerate if treatment is extended to the pediatric population. For medications that address multiple underlying conditions, manufacturers may eventually seek an indication for the treatment of metabolic syndrome. Two diabetes drug classes, the thiazolidinediones and alpha- glucosidase inhibitors, are possible initial candidates for this indication.
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About Medco
Medco Health Solutions (NYSE: MHS - News) is a leader in managing prescription drug programs that are designed to drive down the cost of pharmacy healthcare for private and public employers, health plans, labor unions and government agencies of all sizes. Medco operates the largest mail order and Internet pharmacies and has been recognized for setting new industry benchmarks for pharmacy dispensing quality. Medco, ranked by Fortune Magazine as one of America's "Most Admired" healthcare companies, is a Fortune 50 company with 2004 revenues of $35 billion. Medco is traded on the New York Stock Exchange under the symbol MHS. On the Net: http://www.medco.com
This press release contains "forward-looking statements" as that term is defined in the Private Securities Litigation Reform Act of 1995. These statements involve risks and uncertainties that may cause results to differ materially from those set forth in the statements. No forward-looking statement can be guaranteed, and actual results may differ materially from those projected. We undertake no obligation to publicly update any forward- looking statement, whether as a result of new information, future events, or otherwise. Forward-looking statements in this presentation should be evaluated together with the risks and uncertainties that affect our business, particularly those mentioned in the Risk Factors section of the Company's Annual Report on Form 10-K filed with the Securities and Exchange Commission.
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