Considering the fact media these days are constantly badgering society about the health impacts of obesity and our ever-increasing sedentary lifestyles, it should not have come as a shock that a high proportion of the top drugs used by Australians are all cardiovascular related. Combine that with the problematic over-prescribing of common antibiotics and the ever rising prevalence of type two diabetes, and the top 10 medications shouldn’t really have been too hard to guess either.
When looking at the most commonly used drugs within Australia, there were two ways to go about it; Either purely by the number of prescriptions filled for that particular medication each year, or more specifically the number of individuals per 1000 people who take a standardised dose of this medication each day.
Looking directly at the number of prescriptions, it is clear that as a nation we are battling with hypercholesterolemia in high numbers. With over ten million prescriptions filled for both atorvastatin and rosuvastatin, they each claim the gold and silver medals respectively at the top of our list. Not only this, but when comparing these drugs with lists from the previous year, yet again they were highly featured with atorvastatin remaining as number one and rosuvastatin claiming third, showing a trend which can be traced back for a number of years.
To fill out the top three by prescription numbers from July 2016-June 2017, esomeprazole took the bronze with around six and a half million scripts filled within the twelve month period. Whilst this was a drop from second place during the previous year, the notably high positions of both itself and its fellow proton-pump inhibitor pantoprazole (fourth place, up from fifth the previous year) shows that conditions such as GERD and gastric ulcers are becoming more and more prevalent amongst the community. Whether this can be associated with an increase in the self-use of OTC anti-inflammatories, or an increase in fatty or spicy foods within the diets of Australians may be up for speculation, however the numbers speak for themselves.
Rounding out the top ten by prescription count are commonly prescribed antibiotics such as amoxicillin and cephalexin, as well as medications for blood pressure and diabetes. However, some observations that can be made from this list are the high number of antibiotic scripts being filled within Australia. With the total count of the top three exceeding fifteen million, it is clear that a high proportion of Australians have undergone courses of antibiotics under the recommendation of doctors, especially considering the population of Australia currently sits at around 24 million people.
On the other hand, when analysing the medications used by the Australian population, the best measure to gain some perspective on the number of people taking drugs for chronic conditions is to look at the number of individuals per 1000 people who take a standard daily of dose of a specific medication. And when looking at the list, the prevalence of cardiovascular conditions such as hypertension and hypercholesterolemia are huge, with eight of the top ten medications coming under the umbrella of cardiovascular medications.
And once again taking the top two spots, and not surprisingly after our previous list, were HMG-CoA reductase inhibitors atorvastatin and rosuvastatin. Not only are these drugs considered highly effective at lowering patient’s cholesterol levels, but they are also very easily accessed due to their relative low price point. Not only that, but their positive effects are easily monitored by doctors through a simple blood test.
Rounding out the top three within Australia was perindopril, an ACE inhibitor commonly prescribed for the lowering of blood pressure, as well as for patients with established coronary heart disease in order to lower the risk of a myocardial infarction. And while it is a first line therapy choice for patients with hypertension, it also needs to be monitored carefully, particularly amongst patients taking diuretics or NSAIDs. This is due to what we call the ‘triple whammy effect’ which actually reduces the effectiveness of the ACE inhibitor in controlling a patient’s blood pressure. However, like the statins, perindopril is also an easy to access medication with relatively low prices.
Now when compiling this list there are some medications which were not counted, presumably as they are not covered by the Pharmaceutical Benefits Scheme, and in fact cheaper to purchase over the counter without a script or even simply more convenient. So, whilst there are a large number of patients regularly taking high dose paracetamol in order to control pain, and there are large numbers of salbutamol inhalers being sold daily within pharmacies around the country in order to control asthma symptoms, they are not shown as part of these statistics.
When looking at the drugs that are regularly used by Australians it is clear that our cardiovascular health is deteriorating as a nation. If a prediction was to be made about future lists and medication use for the years to come, we could probably say that these figures are unlikely to change a lot as well. But if one thing is for sure, it is that with the ever increasing demand of medication usage in Australia, the need for helpful and involved pharmacists is as high as ever.
Figures and statistics obtained from The Commonwealth of Australia’s Department of Health and published on NPS Medicine Wise. Links to the top drug tables from both 2016-17 and 2015-16 can be found below.
Top Drugs in Australia 2016-2017-https://www.nps.org.au/australian-prescriber/articles/top-10-drugs-2016-17
Top Drugs in Australia 2015-2016-https://www.nps.org.au/australian-prescriber/articles/top-10-drugs-2015-16