Spending on psychotherapeutic drugs soars

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Spending on antidepressants and other prescription drugs to treat mental disorders climbed from $7.9 billion in 1997 to $20 billion in 2004, an increase of more than 150 percent, a new federal report says.

"It is quite an increase. It is an important thing to take note of," said Marie N. Stagnitti, the report's author and a senior survey statistician with the U.S. Agency for Healthcare Research and Quality. The agency is part of the Department of Health and Human Services.

Purchases of psychotherapeutic drugs rose from 141.9 million to 244.3 million during the seven-year period. The number of people who reported buying these drugs increased from 21 million to 32.6 million during that time.

The study found that antidepressants accounted for more than half ($12.1 billion) of the total expenditures for psychotherapies in 2004. Spending for those drugs, which include commonly prescribed medicines such as Prozac, Paxil and Zoloft, more than doubled from $5.1 billion in 1997.

The total number of antidepressant purchases skyrocketed from 88.3 million in 1997 to 161.2 million in 2004, and the number of people who reported making such purchases increased from 15.3 million to 24.8 million.

The study found that the sharpest rise in spending was for antipsychotic agents, or medications used to manage schizophrenia, bipolar disorder and other psychotic disorders. Total purchases to treat these conditions more than tripled -- from $1.3 billion to $4.1 billion.

Likewise, total expenditures for central nervous system stimulants to treat pain and control seizures nearly tripled during the seven years -- from $600 million to $1.7 billion. The number of people who said they bought at least one of these drugs increased from 2.1 million to 3.3 million, and the total number of purchases of such prescriptions swelled from 11.8 million to 19.7 million.

Meanwhile, purchases of sedatives, hypnotics and medicines to ease anxiety nearly doubled from $900 million to $2.1 billion. Total purchases of those drugs climbed from 24.5 million to 39 million, and the number of people who said they bought at least one of those drugs surged from 5.4 million to nearly 8 million.

Ms. Stagnitti said she is interested in doing more research in this area to determine factors involved in the increase. She thinks it is important to determine how socioeconomic background and insurance coverage influence access to drugs to improve mental health.

Attempts to get reactions Friday from professional or advocacy organizations such as the American Psychiatric Association and Mental Health America were unsuccessful.

But the National Institutes of Mental Health (NIMH) said on its Web site the "burden of psychiatric conditions has been heavily underestimated."

It said a massive study called the "Global Burden of Diseases" found that mental illness accounts for more than 15 percent of the disease burden in established market economies, such as the United States. "This is more than the disease burden caused by all cancers," NIMH said.