Whatever happened to the lifestyle drugs

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• Whateverhappened to the lifestyle drugs?

William Horsley Gillian Masters Regional Drug
Therapeutics Centre, Newcastleand Dr Wasim
Baqir North Tyneside General Hospital
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September 1998
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Viagra to flood NHSMirror 21/9/98Viagra will
cost the NHS 50m a yearThe Times
11/9/98Health Chiefs Ban Too Costly
ViagraDaily Mirror 13/9/98 We Wont Charge
NHS Stiff Price For ViagraThe Sun 11/9/98
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Viagra decision reveals half-baked rationing
in NHSThe Times 18/9/98
Premature Elimination
Viagras First FlopThe Mirror 15/9/98
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Obesity Pill May Add to NHS Budget
StrainGuardian 22/9/98Anti-Obesity Pills That
Could Cost NHS 750m a YearDaily Mail
21/9/98Fat-Less Pills Could Gobble Up NHS
CashThe Sun 21/9/98Obesity Treatment Could
Cost 500mThe Times 21/9/98
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Viagra is licensed in Europe but rationed in
BritainBMJ 19/9/98Flushing away the fat BMJ
26/9/98Viagras ups and downsThe Lancet
19/9/98NHS Moves To Restrict Viagra
PrescribingPJ 19/9/98
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Method

• Download data for NE SHA(no boundary changes)
• Convert to daily dose equivalents (bupropion,
  orlistat and sibutramine) or actual number of
  doses (PDE5Is)
• Plot monthly incidence and cumulative charts for
  doses and cost

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Bupropion
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Orlistat sibutramine
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Phosphodiesterase inhibitors
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All lifestyle drugs (excl. rimonabant
varenicline)
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What is the burden?

• Nearly 25 million over five years for a SHA with
  a population of 2.6 million
• Five years ago these drugs accounted for monthly drug expenditure
• Now they account for nearly 1.5
• Growth in prescribing and cost has accelerated in
  recent years

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but ..

• Containment has been achieved through active
  management and legislative restriction
• Prescribing rates and cost growth are
  accelerating
• Lifestyle drugs may require more intensive and
  pro-active management to prevent them realising
  the predictions that were made when they were
  launched

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