The Elderly and Drug Policy: Coming of Age

From Health Affairs

By Jerry Avorn, MD

SUMMARY: This Health Affairs editorial introduction by Dr. Avorn opens a thematic issue devoted to the relationship between prescription drugs and the elderly population. Avorn, identified as one of very few academically affiliated physicians specializing in this area, provides an overview of the issue's scope, which spans geriatric drug development, elderly participation in clinical trials, pharmaceutical pricing, drug utilization patterns, medication use in long-term care settings, the effects of aging on drug metabolism and response, and the role of federal agencies in regulating drugs for older Americans. The piece situates these topics within the political and policy context of 1990, as Medicare and Medicaid drug coverage debates were intensifying.

BACKGROUND: In 1990, the relationship between prescription drugs and elderly patients was an underexplored area, with few academically affiliated physicians specializing in geriatric pharmacology or drug policy for older populations.

KEY FINDINGS: The thematic Health Affairs issue covers geriatric drug development and regulation, elderly participation in clinical trials, pharmaceutical pricing, drug utilization, medication use in long-term care, pharmacokinetic changes in aging, and the role of federal agencies.

IMPLICATIONS: Dedicated policy and research attention to the relationship between aging and prescription drugs — including clinical trial inclusion, appropriate dosing, and long-term care prescribing — is essential to ensuring medication safety and effectiveness in the elderly population.