Background Population ageing is likely to place an increasing burden on future health care budgets. Several studies have demonstrated that the impact of ageing on future hospital expenditures will be overestimated when not accounting for proximity to death. This is because greater health care expenditure among the elderly partly is due the high "costs of dying". Aims The aim of this study was to estimate the impact of the ageing Danish population on future total expenditures on out-of-hospital prescription drugs and to describe the association between age and drug expenditure among survivors compared to that of decedents. Methods Taking expenditure during the last year of life and the changes in mortality rates into account, future drug expenditure was projected by multiplying estimated mean annual drug expenditure according to age, gender and survival status by the predicted future number of Danes in each stratum, summing up across all strata. The projection was based on current drug utilisation from a representative prescription database covering the county of Funen, Denmark, and the most recent Danish population forecast for the period 2003-2030. Results The population was projected to increase by 0.8% during the period 2003-2030, while the increase was 58% for people aged 75 years and over. Drug expenditure was projected to increase by 16.9% during the same period when accounting for proximity to death, while it was 17.9% when this was not done. We conclude that the ageing of the population is likely to increase future expenditure on prescription drugs - accounting for proximity to death or not. This predicted increase, however, is small compared to recently observed increases in drug expenditures. The projected growth in drug expenditure was not merely due to drug consumption of the elderly. Moreover, the drug expenditure of elderly decedents was only increasing slightly with proximity to death.
aldring lægemiddelomkostninger; ageing drug costs
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Nordic Meeting on Register-based Health Research, 2009