Americans waste $163 billion annually due to behaviors relatedto prescription drugs - like forgetfulness and procrastination -according to a report from pharmacy benefit management company Express Scripts.

The company says the new report is the first ever to analyzethese hidden health care costs related to prescription drugs. TheExpress Scripts 2009 Drug Trend Report - which has beenreleased annually for the past 14 years - quantifies changes indrug spend on a year-to-year basis and details the costly effectsof irrational behaviors on pharmacy-related costs.

According to Express Scripts, the $163 billion in wastefulspending results from three key factors:

• $106 billion from medical costs of non-adherence totherapy.
• $51 billion in missed opportunities related to lower-costmedication alternatives, both brand and generic.
• $6 billion in missed opportunities related to lower-costoptions for delivery of medications.

Express Scripts says it is the first company to "applybehavioral science to address healthcare challenges thatindividuals, policymakers and employers have faced for years."

"The good news is that these potential savings in the pharmacybenefit are tied to one of the few variables in healthcare we canreadily influence: behavior," said Steven Miller, MD, senior vicepresident and chief medical officer at Express Scripts. "Thisresearch shows that in terms of achieving lower costs and improvedoutcomes, healthcare reform starts in the home."

Miller added, "If we optimized every individual's behaviorrelating to prescription drugs, we could achieve savings that infive years would cover the projected costs of the recently passednational healthcare reform legislation."

The report links spending to both market forces and behavioralfactors. Overall, the drug spend for the United States increased6.4 percent in 2009, reversing a pattern of lower drug trendincreases in previous years, the report says. Market forces drovetrend up by 8.3 percent, while behavior drove down trend by nearly2 percent.

The Drug Trend Report also concludes that diabetes is the topdriver of total cost increases in the traditional drug sectorbecause of growth in utilization and cost per prescription.Spending for drugs used to treat viral infections increased byapproximately 25 percent primarily because of increased prevalenceof use for agents used to treat influenza.