Does US have a national strategy to reduce Rx drugs consumption?

Question

According to this article, Rx drug usage has greatly increased in the last 20 years:

The total number of prescriptions has increased by 85% while the total population has increased by only 21%.

I tried to find if there is any concern at national level and only being able to find about President Obama’s Strategy to reduce the shared threat of [illegal] drug use and its consequences:

Reducing the demand for drugs in the United States is the underlying theme that drives President Obama’s Strategy to reduce the shared threat of drug use and its consequences.

Question: Does US have a national strategy / public policy to reduce Rx drugs consumption?

Answer 1

STAT News (2019) - Overprescribed: High cost isn't America's only drug problem

The pharmaceutical industry has followed a brilliant two-pronged strategy to maximize its profits: raise prices and increase consumption of medications.

Most of the attention has focused on just one side of the equation — prices. With politicians and advocates on both sides of the aisle vowing to lower drug prices, few people are talking about Americans being overprescribed medications, which not only adds to the cost of drugs but also harms millions of Americans each year.

This implies to me that there may not be much of an effort to deal with the overprescription problem in the United States as there is much more focus on drug prices in general. Furthermore, one way to read this is that if drug prices are reduced, pharmaceutical companies may be driven to further increase prescription rates in order to retain current levels of profits.

Between 2000 and 2012, the proportion of adults in the U.S. who were taking five or more medications nearly doubled, from 8.2 percent to 15 percent.

...

Older Americans are particularly vulnerable to medication overload. Today, 42 percent of adults over the age of 65 take five or more medications — a red flag for harm. The rapid increase in the number of medications older people are taking has led to a sharp rise in serious side effects, known clinically as adverse drug events.

There is undoubtedly a rise in prescription rates in Americans, and this appears to be a problem that should be addressed. In regards to your question, this would mean that overprescription is an issue that needs dealing with, so the lack of nationwide policy is not because rising prescription rates are acceptable.

Lown Institute - Medication Overload: How the drive to prescribe is harming older Americans

A broad array of forces is at work, with three overarching aspects of our health care system contributing to the epidemic:

Culture of Prescribing – Advertisements linking prescription medications to happiness and health, the increased medicalization of normal human aging, the hurried pace of medical care, and the desire of both health care professionals and patients to “do something” have fostered a shared expectation that there is a “pill for every ill.”

Information & Knowledge Gaps – Clinicians and patients lack critical information and skills they need to appraise the evidence and make informed decisions regarding medications.

Fragmentation of Care – There is a pervasive lack of communication between a patient’s various providers. Often, more prescriptions are written to treat what appears to be a new condition, when in reality prescribers are treating a side effect of another drug. This “prescribing cascade” can lead to a cycle of debilitation and even death.

Policies attempting to deal with the overprescription issue would probably focus on one or more of the three broad areas given in the prior quotation. Looking through ProPublica's list of Bills About Health from the 116th Congress, I don't see anything that really addresses overprescription rates. I had initially picked out a few that could possibly help, but the connections to overprescription rates was very tenuous. They were mostly focused on either increasing the supply of medical professionals or in curbing the effects of the opioid epidemic caused by overprescription of opioid medications. Ultimately, I realized that they were irrelevant to this discussion because they are not being proposed as part of an overall strategy to deal with the rising prescription rates in this country.

Furthermore, in trying to focus on bills relating to pharmaceutical companies, the focus of any relevant bills seems to be on the issue of drug prices rather than on their push to increase prescription rates. Or if the bill did focus on deceptive marketing techniques to increase prescription rates, it was in the context of specifically opioid prescriptions rather than overall prescriptions.

When narrowing down to bills relating to prescriptions, most of the bills are still focused either in controlling the prices of prescription medications or dealing with overprescription of opioids.

As best as I can tell, the STAT News article that I cited above seems correct: "few people are talking about Americans being overprescribed medications[.]" So, as difficult as it is to provide a negative answer, I would say that, as best as I can tell, the US does not have a national strategy to reduce prescription drug consumption.

Answer 2

If the goal is to reduce healthcare costs, then reducing the cost of drugs seems like a much more important strategy than reducing the number of prescriptions. According to statista expenditure has about tripled in the last 20 year, and dectupled in the last 30. (It does not specify nominal dollars or real dollars.)

There are definitely some plans for reducing the ballooning cost of prescription drugs.

1: Allowing medicare to negotiate drug prices

When Congress created Medicare Part D, it prohibited Medicare from negotiating with drug companies for lower drug prices. The removal of this restriction has been advocated in order to prevent pharmaceutical companies from setting prices unilaterally. Note that this is not price control, they are not forced to lower their prices in general.

2: Allowing the government to regulate drug prices

Unlike the previous solution, this would allow the government to unilaterally set a price cap on certain drugs to whomever they are selling. Advocates claim that pharmaceutical companies are jacking up prices to such an extent that they can still make plenty of profit with lower prices, but opponents claim that the price controlled drugs will become unavailable or underavailable since it will not be as profitable to produce.

3: Altering patent law for drugs

Since for the first 20 years after producing a drug all other competition is prevented by patent law, pharmaceutical companies can charge whatever they want and anybody who wants the drug will need to pay for it. By removing this, competition would increase and lower prices. While true, this would also have the adverse effect of lowering research and development of new drugs since it would no longer be as profitable.

4. Nationalizing pharmaceutical companies

This is a more radically leftist position to take, but the hope is that if the government took control of drug companies they would not be as profit motivated and would be willing to sell for cheaper. It is debatable whether the end result would be positive, since being profit motivated is the current driver of most drug research going on currently. Additionally, if all companies were nationalized it would remove all competition, which generally leads to more bloat and less efficient production.

5. Decreasing FDA regulation standards

Because of the large amount of testing required to be allowed to produce drugs, it can be difficult for smaller companies to enter the scene (there is a huge amount of time and money involved). One suggestion is to decrease the amount of testing required to be approved to create a generic version that is already on the market. Since a chemically identical drug has already been produced, there is not as much need to test that it is safe. You can get equivalent pills from foreign countries for a few cents on the dollar because they do not require the same level of testing. The obvious concern is that this would decrease the safety of the drugs, but proponents believe that many of the regulations do not significantly improve safety. Some radical libertarians propose getting rid of all regulations, but that is not a mainstream view.

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_{This all might have been better as a comment since it doesn't answer the title question, but it would not have fit. Also you clarified the primary motivation was to reduce drug prices, so I hope this was still valuable.}