Metabolic medicines were the course of medications with the highest level of spending in 2008. According to data from the federal agency, buys of metabolic medicines by adults age 18 and older accounted for 22 % of the nearly $233 billion spent overall to get prescription medicines in 2008. Overall purchases of these five therapeutic classes of medicines totaled nearly $156 billion, or two-thirds of the nearly $233 billion that was spent on prescription medicines found in the outpatient treatment of adults.. AHRQ: $52.2 billion spent on prescription drugs for treatment of metabolic conditions during 2008 Insurers and customers spent $52.2 billion on prescription medications in 2008 for outpatient treatment of metabolic conditions such as diabetes and elevated cholesterol, based on the latest Information and Quantities from the Agency for Healthcare Study and Quality .One is certainly that in specific fields, authors could be best qualified to suggest suitable reviewers for the manuscript and topic in question. Another can be that it creates life less complicated for editors: finding appropriate peer reviewers who are willing to review in a timely manner can be both hard and time consuming. A third reason may be that journals and publishers are increasingly multinational. During the past, the editor and editorial plank of a journal understood both scientific field it covered and the people employed in it, but it’s extremely difficult to become sufficiently well connected when both editors and submissions come from all over the world. Having authors suggest the very best reviewers may therefore seem like a good idea. In the aftermath of the latest scandals involving fake peer reviewers, many journals have decided to turn off the reviewer-recommendation option on their manuscript-submission systems.