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Atypical antipscychotics- The assault on our senior citizens

Posted May 10 2011 10:41pm

The article linked below makes me want to scream!!!!  It describes what looks like a concerted effort on the part of pharmaceutical companies to literally put the lives of thousands of senior citizens at risk so they can make a buck.  It also describes how governmental agencies and insurance companies ignore existing regulations which already make this entire effort illegal.  It tells a story of shame.  Highlighting drug industry influence, watchdog says overmedication in nursing homes Is troubling » Knoxville News Sentinel .

Here are some of the main points the article makes:

  • In 2005 the government mandated that drug manufacturers put a warning on the label of the anti-psychotics stating they are not recommended for the old people with dementia,  that in fact, they may result in their early death.  Quoting the article, “Yet when the government examined 1.4 million Medicare claims from 2007 for atypical antipsychotics for elderly nursing home residents, the government found that 88 percent of the time, the drugs were prescribed to individuals diagnosed with dementia.”
  • HHS Inspector General Daniel Levinson adds, ““Despite the fact that it is potentially lethal to prescribe antipsychotics to patients with dementia, there’s ample evidence that some drug companies aggressively marketed their products towards such populations, putting profits before safety,”
  • The report also criticizes CMS (Center for medicaid and medicaire services) for not holding nursing homes responsible for this manner of prescribing antipsychotic medication.  Among the problems it noted as being widespread are inadequate rationale for the use of the drugs, excessive doses, excessive duration, and inadequate monitoring of the patients given medication.
  • And finally the report says that medicaire paid out over 116 million in claims made for this medication that violated standards for reimbursement.  And that was only for the first half of 2007.  You can only wonder what that figure is now.

As a citizen of Tennessee I read this article and fear that countless thousands of Tennessee’s senior citizens may be in danger.  Perhaps in danger for their very lives.  The report though informative leaves me with lots of questions and concerns:

  1. To what extent are Tennessee’s senior citizens in nursing homes who suffer with dementia being prescribed atypical antipsychotics?
  2. The report identifies medicaire as a primary source of this problem.  Regulations are just not enforced.  My question though is to what extent is TennCare part of the problem?  How much does the off label use of antipschotics in vulnerable populations drive up medicaid costs.  Recently Tennessee accepted a multi million dollar settlement in a suit against the makers of Seroquel for attempting to increase the off label use of Seroquel.  It is an acknowledged problem.
  3. If TennCare is reimbursing the use of atypical antipsychotics with dementia patients is that not a violation of their reimbursement policies.  If that is not a violation why is it not?  Surely the state can protect its oldest citizens in their worst times much better than this.
  4. If atypical antipsychotics adversely affect the health of the elderly is TennCare not reimbursing for that also?  Are the medicines we reimburse for also causing illnesses that we must also reimburse for?
  5. In a time when Tenn Care costs are raising and the threat of loss of services is real I seriously object to this practice.  If it is as large of a problem as it seems it might be it threatens many people either directly or indirectly.
  6. It seems to me to be a system of much profit based on much misery.  Drug companies profit, doctors profit, nursing homes have more docile patients, managed care companies profit.  They keep a percentage of what the state pays them for profit.  The more they get paid the larger that percentage is in dollars and cents.

Something is very wrong with this picture.  If you have a relative in a nursing home, or know someone in a nursing home do you begin to realize what this means for them?  If you do not live in Tennessee have you looked into your state to figure how big a problem it is?  And if you are a public official why is something liking this happening on your watch?

I hope that if you have read this post and the article it links to that you too are horrified.  I hope you too want to scream.  And I hope that all of us act.

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