A pill for every ill?

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Sensible precautionary medication to ward off future ailments or a worrying trend underpinned by an assumption there is "a pill for every ill"?

The debate has been rekindled with the publication of the latest Health Survey for England, and there are no easy answers.

This is the first time the use of prescribed medicines has been included in the survey, so there is no comparison with previous years.

It's difficult to know how surprised we should be that half of women and more than four in 10 men surveyed said they had taken at least one prescription medicine during the past week.

A £15bn total bill for drug costs in hospitals and the community in England last year in some ways sounds reasonable, given that the total NHS budget was about £100bn.

Older and fatter

There is a growing and ageing population. Frail elderly patients with multiple conditions are living longer. The increase in obesity and rise in type-2 diabetes, also highlighted in the survey, are other factors that put pressure on the NHS and raise demand for medicines.

Most medical professionals will argue strongly that statins, properly prescribed, bring great benefits to patients by reducing the risk of heart problems and so help the NHS by reducing future treatment costs.

The same arguments apply to blood pressure medication, because stroke risk is curbed.

Anti-depressants, sometimes only taken for a limited amount of time, clearly have a place in improving a patient's quality of life.

Too much?

And yet... are we popping too many pills? Could the costs get out of control?

The number of prescribed items in the community has accelerated faster than the population.

In 2003 in England, there were just under 650 million community prescription items, the number rising to more than a billion in 2013.

It is worth noting that the total cost of the items dispensed in community in 2013 was up just 1% on the previous year, below the rate of inflation.

The fact that statins were among the most frequently reported prescribed medicines may not come as a surprise, but this survey was conducted before the recent relaxation of guidelines for their use.

The National Institute for Health and Care Excellence has recommended that they be prescribed to people with a one in 10 risk of developing a heart condition rather than the previously stated one in 20.

Future years' data on the extent of statin use will be watched closely.

It's a big question for society. Should we all take more responsibility for our lifestyles and get fitter so the risk of future medical problems is reduced?

Doing that would cut the numbers on medication and lower the bills for future taxpayers.

Or perhaps people may feel that in a civilised 21st Century economy there is an entitlement to the best life-enhancing treatments and drugs medical science can offer.

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