Agency for Healthcare 

Medical Expenditure Panel Survey Research and Quality 

STATISTICAL BRIEF #91 

July 2005 

The Top Five Therapeutic Classes 

of Outpatient Prescription Drugs, 

by Total Expenses for the Elderly 

and Near Elderly in the U.S. Civilian 

Noninstitutionalized Population, 2002 

Marie N. Stagnitti, MPA 

Introduction 

This Statistical Brief provides a summary of the top five therapeutic 

classes of outpatient prescription drugs for the elderly (age 65 and 

older) and the near elderly (age 55–64), when ranked by total 

expenses, as reported by households in the U.S. civilian noninstitutionalized population in calendar year 2002. The brief also 

provides estimates for the elderly and the near elderly on the percentage of total prescribed drug expenses the top five therapeutic 

classes represent, the percentage having an expense in these 

classes of drugs, and the mean expenses in these classes of drugs 

for those with an expense. 

The estimates in this brief are derived from the Household Component of the 2002 Medical Expenditure Panel Survey (MEPS-HC). 

Over-the-counter drugs and free samples are not included in these 

estimates. All results discussed are statistically significant at the 0.05 

level. 

Findings 

Elderly 

In 2002, the top five therapeutic classes for prescribed drugs 

purchased by the elderly age 65 and older, when ranked by annual 

expenses, totaled $36.5 billion and represented 73.1 percent of the 

$49.9 billion total expenses by the elderly (persons age 65 and older) 

for prescription drugs (estimates not shown). Cardiovascular agents 

ranked first in terms of total expenses at $13.0 billion, which was 

higher than total expenses spent on any of the remaining top two to 

five therapeutic classes: hormones ($7.2 billion), antihyperlipidemic 

agents (6.7 billion), central nervous system agents (5.3 billion), and 

gastrointestinal agents (4.3 billion) (figure 1). 

Highlights 

� In 2002, the first four of the 

top five therapeutic classes of 

prescription drugs were the 

same for the elderly and near 

elderly (one, cardiovascular 

agents; two, hormones; three, 

antihyperlipidemic agents; 

four, central nervous system 

agents). 

� The top five therapeutic 

classes of prescription drugs 

represented 73.1 percent of 

the $49.9 billion spent by the 

elderly on prescription drugs 

and 68.8 percent of the $31.1 

billion spent by the near 

elderly on prescription drugs 

in 2002. 

� In 2002, cardiovascular 

agent prescription medicine 

expenses accounted for 

approximately one-quarter of 

total prescription drugs 

expenses for the elderly (26.0 

percent) and nearly one-fifth 

of total expenses for the near 

elderly (19.0 percent). 

� Over 70 percent of the elderly 

had a cardiovascular agent 

expense (71.2 percent) and 

about half of the near elderly 

had such an expense (50.7 

percent) in 2002. 

� In 2002, antihyperlipidemic 

agents had the highest 

average expense for the 

elderly and near elderly, when 

comparing mean expenses 

for the top five therapeutic 

classes ranked by total 

expenses ($100.30 and 

$88.12, respectively). 
In 2002, expenses on cardiovascular agents represented 26.0 percent of total expenses spent on 

prescription drugs by the elderly, which was higher than the percentages for hormones (14.4 percent), 

antihyperlipidemic agents (13.5 percent), central nervous system agents (10.6 percent), and gastrointestinal agents (8.7 percent). The percentage of total expenses spent on hormones by the elderly (14.4 

percent) was greater than the total expenses spent on central nervous system agents (10.6 percent) and 

gastrointestinal agents (8.7 percent). Furthermore, the percentage of total prescription drug expenses by 

the elderly spent on antihyperlipidemic agents (13.5 percent) was higher than the percentage spent on 

central nervous system agents (10.6 percent) and gastrointestinal agents (8.7 percent). (figure 2) 

In 2002, the percentage of the elderly population that used a drug in the top five therapeutic classes of 

prescription drugs, when ranked by total expenses, was highest for cardiovascular agents. Over 70 

percent of the elderly (71.2 percent) used a cardiovascular agent, which was higher than the percentages 

using prescription drugs in any of the remaining top five therapeutic classes (hormones, 48.2 percent; 

antihyperlipidemic agents, 33.4 percent; central nervous system agents, 46.2 percent; and gastrointestinal agents, 25.5 percent). Central nervous system agents were fourth in terms of total expenses 

spent on prescription drugs by the elderly, and a higher percentage of the elderly purchased those types 

of drugs (46.2 percent) than antihyperlipidemic agents (33.4 percent) or gastrointestinal agents (25.5 

percent), which ranked third and fifth, respectively, in terms of total expenses. The percentage of the 

elderly using hormones (48.2 percent) was higher than those using antihyperlipidemic agents (33.4 

percent) and gastrointestinal agents (25.5 percent), and the percentage using antihyperlipidemic agents 

(33.4 percent) was higher than the percentage using gastrointestinal agents (25.5 percent). (figure 3) 

Of the top five therapeutic classes, when ranked by total expenses for the elderly in 2002, antihyperlipidemic agents had a higher mean expense ($100.30) than cardiovascular agents ($42.59), hormones 

($51.14), or central nervous system agents ($52.17). Gastrointestinal agents had the second highest 

mean expense at $89.72, which was higher than the mean expense for central nervous system agents 

($52.17), hormones ($51.14), and cardiovascular agents ($42.59). Moreover, cardiovascular agents had 

the lowest mean expense at $42.59, as compared with all other mean expenses of the top five therapeutic classes for the elderly in 2002. (figure 4) 

Near elderly 

In 2002, the top five therapeutic classes for household-reported prescribed drugs purchased by the near 

elderly (persons age 55–64), when ranked by annual expenses, totaled $21.4 billion and represented 

68.8 percent of the $31.1 billion total expenses for the near elderly for prescription drugs (estimates not 

shown). Cardiovascular agents ranked first in terms of total expenses on prescription drugs for the near 

elderly at $5.9 billion, which was higher than total expenses spent on the top three to five therapeutic 

classes (antihyperlipidemic agents (3.9 billion), central nervous system agents (3.9 billion), and psychotherapeutic agents (2.8 billion), respectively). Total expenses spent on hormones ($4.9 billion, second in 

top five) was higher than total expenses spent on psychotherapeutic agents by the near elderly ($2.8 

billion, fifth in top five). (figure 1) 

In 2002, expenses on cardiovascular agents represented 19.0 percent of total prescription drugs 

expenses for the near elderly, which was higher than the percentage of total drug expenses spent on 

antihyperlipidemic agents (12.5 percent), central nervous system agents (12.4 percent), and psychotherapeutic agents (9.1 percent). Furthermore, the percentage of total prescription drug expenses spent 

on hormones (15.8 percent) and antihyperlipidemic agents (12.5 percent) by the near elderly was higher 

than the percentage spent on psychotherapeutic agents (9.1 percent) in 2002. (figure 2) 

In 2002, a higher percentage of the near elderly used cardiovascular agents (50.7 percent) than 

antihyperlipidemic agents (29.1 percent) and psychotherapeutic agents (21.0 percent), and the 

percentage using hormones (48.4 percent) was higher than the percentage using antihyperlipidemic 

agents (29.1 percent) and psychotherapeutic agents (21.0 percent). Moreover, a higher percentage used 

central nervous system agents (46.3 percent) than antihyperlipidemic agents (29.1 percent) or psychotherapeutic agents (21.0 percent), and a higher percentage used antihyperlipidemic agents (29.1 percent) 

than psychotherapeutic agents (21.0 percent). (figure 3) 

Among the top five therapeutic classes for the near elderly, when ranked by total expenses on 

prescription drugs in 2002, antihyperlipidemic agents had the highest mean expense ($88.12) as 

compared with the mean expense for the remaining four classes (cardiovascular agents, $43.09; 

hormones, $51.02; central nervous system agents, $55.28; and psychotherapeutic agents, $70.80). 
Cardiovascular agents had the lowest mean expense at $43.09. The mean expense for psychotherapeutic agents for the near elderly ($70.80) was higher than the mean expense for hormones 

($51.02) and central nervous system agents ($55.28). (figure 4) 

Definitions 

Therapeutic classes were assigned to drugs using Multum Lexicon variables from Cerner Multum, Inc. 

For additional information on these and other Multum Lexicon variables, as well as the Multum Lexicon 

database itself, please refer to the following Web site: http://www.multum.com/Lexicon.htm

About MEPS-HC 

MEPS-HC is a nationally representative longitudinal survey that collects detailed information on health 

care utilization and expenditures, health insurance, and health status, as well as a wide variety of social, 

demographic, and economic characteristics for the civilian noninstitutionalized population. It is cosponsored by the Agency for Healthcare Research and Quality and the National Center for Health Statistics. 

For more information about MEPS, call the MEPS information coordinator at AHRQ (301-427-1656) or 

visit the MEPS Web site at http://www.meps.ahrq.gov/. 

References 

For a detailed description of the MEPS survey design, sample design, and methods used to minimize 

sources of nonsampling error, see the following publications: 

Cohen, J. Design and Methods of the Medical Expenditure Panel Survey Household Component. MEPS 

Methodology Report No. 1. AHCPR Pub. No. 97-0026. Rockville, Md.: Agency for Health Care Policy and 

Research, 1997. 

Cohen, S. Sample Design of the 1996 Medical Expenditure Panel Survey Household Component. MEPS 

Methodology Report No. 2. AHCPR Pub. No. 97-0027. Rockville, Md.: Agency for Health Care Policy and 

Research, 1997.

Cohen, S. Design Strategies and Innovations in the Medical Expenditure Panel Survey. Medical Care, 

July 2003: 41(7) Supplement: III-5–III-12. 

Suggested Citation 

Stagnitti, M. N. The Top Five Therapeutic Classes of Outpatient Prescription Drugs, by Total Expenses 

for the Elderly and Near Elderly in the U.S. Civilian Noninstitutionalized Population, 2002. Statistical Brief 

#91. July 2005. Agency for Healthcare Research and Quality, Rockville, Md. http://www.meps.ahrq.gov/ 

papers/st91/stat91.pdf 
24.9 

21.4 

18.3 

15.1 

14.3 

$0 

$5 

$10 

$15 

$20 

$25 

$30 

18 and older adult population 

Cardiovascular agents 

Hormones 

Figure 1. Top five therapeutic classifications for 

13.0 

7.2 6.7 

5.3 4.3 

$0 

$5 

$10 

$15 

$20 

$25 

$30 

elderly 

Cardiovascular agents 

Hormones 

Gastrointestinal agents 

5.9 

4.9 3.9 3.9 

2.8 

$0 

$5 

$10 

$15 

$20 

$25 

$30 

near elderly 

Cardiovascular agents 

Hormones 

Psychotherapeutic agents 

In billions 

Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey, 2002 

Central nervous system agents 

Psychotherapeutic agents 

Antihyperlipidemic agents 

prescribed drugs, when ranked by total expense 

for the elderly and near elderly, 2002 

Antihyperlipidemic agents 

Central nervous system agents 

Antihyperlipidemic agents 

Central nervous system agents 

Figure 2. Percentage of annual prescribed drug expenses for 

26.0 

14.4 13.5 

10.6 

8.7 

0% 

5% 

10% 

15% 

20% 

25% 

30% 

elderly 

Cardiovascular agents 

Hormones 

Gastrointestinal agents 

19.0 

15.8 

12.5 12.4 

9.1 

0% 

5% 

10% 

15% 

20% 

25% 

30% 

near elderly 

Cardiovascular agents 

Hormones 

Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey, 2002 

the elderly and near elderly the top five therapeutic classes 

represent, when ranked by total expense, 2002 

Antihyperlipidemic agents Central nervous system agents Antihyperlipidemic agents Central nervous system agents 

Psychotherapeutic agents 
expense in the top five therapeutic classes of prescribed 

71.2 

48.2 

33.4 

46.2 

25.5 

0% 

20% 

40% 

60% 

80% 

elderly 

Cardiovascular agents 

Hormones 

Gastrointestinal agents 

50.7 

48.4 

29.1 

46.3 

21.0 

0% 

20% 

40% 

60% 

80% 

near elderly 

Cardiovascular agents 

Hormones 

Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey, 2002 

Figure 3. Percentage of elderly and near elderly having an 

drugs, when ranked by total expenses, 2002 

Antihype rlipidemic agents 

Central nervous system agents 

Antihyperlipidemic agents 

Central nervous system agents 

Psychotherapeutic agents 

with an expense in the top five therapeutic classes of 

42.59 

51.14 

100.30 

52.17 

89.72 

$0 

$20 

$40 

$60 

$80 

$100 

$120 

elderly 

Cardiovascular agents 

Hormones 

Gastrointestinal agents 

43.09 

51.02 

88.12 

55.28 

70.80 

$0 

$20 

$40 

$60 

$80 

$100 

$120 

near elderly 

Cardiovascular agents 

Hormones 

Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey, 2002 

Figure 4. Average expense for the elderly and near elderly 

prescribed drugs, when ranked by total expenses, 2002 

Antihyperlipidemic agents Central nervous system agents Antihyperlipidemic agents Central nervous system agents 

Psychotherapeutic agents