As most of the nation hunkered down amid the coronavirus pandemic, visits to doctor offices and outpatient clinics plunged. That’s helping cause major swings in prescription drug use.
Express Scripts, a top prescription benefit manager with over 100 million customers, saw big jumps in people getting three-month refills via mail delivery, as people with chronic health problems stocked up early in the crisis. Refills jumped 18% between mid-March and mid-April.
Then prescription orders started dropping, partly from all the patients who’d just stocked up. Other people lost jobs and health insurance, or avoided medical facilities for fear of catching the virus.
For some types of drugs, orders are bouncing back, and one category has spiked sharply.
The Associated Press discussed the changes with Dr. Glen Stettin, who oversees trend and formulary management at Express Scripts, which is owned by health insurer Cigna.
The conversation has been edited for clarity and brevity.
Q: When did changes in prescription-filling patterns start?
A: The shifts began around Feb. 15, and they peaked the week ending March 15, when the stay-at-home orders started to go into effect.
Q: What’s happened with new prescriptions, ones for medicines a patient hadn’t taken before?
A: Those declined by roughly a third before bottoming out in mid-April. People aren’t getting checkups, so they’re not being diagnosed with conditions like high blood pressure, high cholesterol and diabetes, which have silent symptoms. There’s also been a drop in people being diagnosed with cancer. New prescriptions have been on the rise as shelter-in-place orders are relaxed.
Q: Which medicine category has had the biggest increase in use?
A: We saw large increases in the use of medications for mental health conditions, including antidepressants and medications for anxiety and insomnia, with a 40% increase for anti-anxiety drugs in the first half of March.
Q: Has use of those medicines ever jumped like that before?
A: We did see increases in use in this category after 9/11 and after the 2008 recession, but nothing like this. It’s several times higher.
Q: What medicine categories have seen big decreases in use?
A: Acute care medications, such as antibiotics.
Q: What other trends stand out?
A: Prescriptions for health conditions associated with higher COVID risk — diabetes, high cholesterol, high blood pressure and respiratory issues — increased 21% in March, then decreased 12% in April.
Q: Has Express Scripts offered extra financial aid or other help to patients amid this crisis?
A: With more people feeling stressed, depressed and anxious, we made treatments such as online cognitive behavioral therapy available free to our plan members. We also started Parachute Rx, which offers low co-payments for thousands of drugs to people who have lost insurance coverage and are experiencing financial hardship due to the pandemic, even if they’re not Express Scripts customers.