cribing for six drugs (Prilosec, Zyprexa, Risperdal, Prevacid, Celebrex and Claritin) accounted for more than 25 percent of the total increase in expenditures. They add that some of the drugs with the greatest expenditures in this study are among those with the largest marketing budgets, and they note that for most of the newer drugs, improved cost-effectiveness has not been shown. To help control rising prescription drug expenditures, they suggest that efforts should be undertaken to improve appropriate and cost-effective prescribing. A possible solution to the issue of rising prescription costs is offered in a study by McMullin and colleagues also in this issue of Annals. Their study findings point to the effectiveness of electronic decision support systems in lowering prescription expenditures.
Changing Prescribing Patterns and Increasing Prescription Expenditures in Medicaid
By Kenneth S. Fink, M.D., M.G.A., M.P.H., et al

Fewer Arrests, Auto Accidents and Emergency Room Visits Among Young Adults Counseled About High-Risk Drinking
Physicians who spent only a few focused minutes counseling young patients about reducing their alcohol use successfully reduced high-risk drinking among those patients as well as the number of motor vehicle crashes, arrests for substance or liquor violations and emergency room visits. Analyzing the results from 226 young adults between the ages of 18 and 30 who participated in a randomized clinical trial testing the effectiveness of brief alcohol counseling, the authors found that counseling resulted in long-term reductions in high-risk drinking behaviors and adverse events. Comparing results of those who received counseling with those who did not, the authors found that counseling resulted in a 40 to 50 percent decrease in alcohol use, 42 percent fewer emergency department visits (103 vs. 177), 55 percent fewer motor vehicle crashes (9 vs. 20), and 23 percent fewer total motor vehicle events (
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Contact: Angela Lower
alower@aafp.org
913-906-6253
American Academy of Family Physicians
5-Oct-2004

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