Highlighting Drug Industry Influence, Watchdog Says Overmedication in Nursing Homes Is Troubling

[Guest guest]

Highlighting Drug Industry

Influence, Watchdog Says Overmedication in Nursing Homes Is

Troubling

by n

Wang

ProPublica, May 10, 2011, 2:16 p.m.

Nursing homes are unnecessarily administering powerful

antipsychotic drugs to many elderly residents, including

residents with dementia, according to a new report by the

Health and Human Services inspector general.

The Food and Drug Administration in 2005 mandated that drug

makers issue

warning labels on atypical antipsychotics, noting that the

drugs—which are generally FDA-approved for treating

schizophrenia and bipolar disorder—increase the risk of death

for elderly patients with dementia. 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.

Latest Episode: ProPublica’s Jake Bernstein and

Eisinger give us a behind-the-scenes look at their

Pulitzer prize-winning series, “The Wall Street Money

Machine.”

Listen

»

Doctors and nursing homes aren’t the only ones to blame,

according to HHS Inspector General Levinson. The report

itself does not specifically examine ties between doctors,

pharmacies, and nursing homes, but in a statement

accompanying the report, Levinson faulted drug companies for

aggressively—and illegally—marketing these products to doctors for

treatment of dementia and other off-label uses. (It’s not illegal

for doctors to prescribe drugs for off-label uses, but it is for

drug companies to promote them as such.)

“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,” Levinson

said.

He noted that a number of drug companies have been accused of

illegally promoting these drugs off-label to doctors and

pharmacies, including those that serve nursing home residents.

Some of the lawsuits have settled, but Levin said those

settlements alone don’t negate the effects of years of off-label

promotion.

“Money can't make up for years of corporate campaigns that market

drugs with questionable benefits and potentially deadly side

effects for vulnerable, elderly patients,” according to Levinson.

The report also faulted the Center for Medicare and Medicaid

Services (CMS), the agency that oversees Medicare and Medicaid,

for failing to hold nursing homes accountable for unnecessary use

of antipsychotic drugs. Unnecessary uses can include inadequate

rationale for using the drug as well as excessive doses, excessive

duration, and inadequate monitoring of patients to whom the drug

was given.

The report notes that the federal government paid more than $116

million for claims that violated Medicare reimbursement criteria.

These claims were only for the first half of 2007.

The inspector general recommends that CMS assess its safeguards

for preventing unnecessary antipsychotic drug use in nursing

homes. The agency acknowledged that better controls were needed.

In a letter to the inspector general, CMS Administrator

Berwick wrote that the agency is “very concerned about the nature

of the contractual arrangements” involving nursing homes, the

doctors and pharmacies that serve them, and pharmaceutical

manufacturers.

We’ve reported on some of those ties in our series, Dollars for

Docs. In particular, we highlighted the case of a

psychiatrist who

served Chicago-area nursing homes and made nearly a half

million dollars promoting AstraZeneca’s best-selling

antipsychotic.

Follow on Twitter: @mariancw

[Guest guest]

Highlighting Drug Industry

Influence, Watchdog Says Overmedication in Nursing Homes Is

Troubling

by n

Wang

ProPublica, May 10, 2011, 2:16 p.m.

Nursing homes are unnecessarily administering powerful

antipsychotic drugs to many elderly residents, including

residents with dementia, according to a new report by the

Health and Human Services inspector general.

The Food and Drug Administration in 2005 mandated that drug

makers issue

warning labels on atypical antipsychotics, noting that the

drugs—which are generally FDA-approved for treating

schizophrenia and bipolar disorder—increase the risk of death

for elderly patients with dementia. 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.

Latest Episode: ProPublica’s Jake Bernstein and

Eisinger give us a behind-the-scenes look at their

Pulitzer prize-winning series, “The Wall Street Money

Machine.”

Listen

»

Doctors and nursing homes aren’t the only ones to blame,

according to HHS Inspector General Levinson. The report

itself does not specifically examine ties between doctors,

pharmacies, and nursing homes, but in a statement

accompanying the report, Levinson faulted drug companies for

aggressively—and illegally—marketing these products to doctors for

treatment of dementia and other off-label uses. (It’s not illegal

for doctors to prescribe drugs for off-label uses, but it is for

drug companies to promote them as such.)

“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,” Levinson

said.

He noted that a number of drug companies have been accused of

illegally promoting these drugs off-label to doctors and

pharmacies, including those that serve nursing home residents.

Some of the lawsuits have settled, but Levin said those

settlements alone don’t negate the effects of years of off-label

promotion.

“Money can't make up for years of corporate campaigns that market

drugs with questionable benefits and potentially deadly side

effects for vulnerable, elderly patients,” according to Levinson.

The report also faulted the Center for Medicare and Medicaid

Services (CMS), the agency that oversees Medicare and Medicaid,

for failing to hold nursing homes accountable for unnecessary use

of antipsychotic drugs. Unnecessary uses can include inadequate

rationale for using the drug as well as excessive doses, excessive

duration, and inadequate monitoring of patients to whom the drug

was given.

The report notes that the federal government paid more than $116

million for claims that violated Medicare reimbursement criteria.

These claims were only for the first half of 2007.

The inspector general recommends that CMS assess its safeguards

for preventing unnecessary antipsychotic drug use in nursing

homes. The agency acknowledged that better controls were needed.

In a letter to the inspector general, CMS Administrator

Berwick wrote that the agency is “very concerned about the nature

of the contractual arrangements” involving nursing homes, the

doctors and pharmacies that serve them, and pharmaceutical

manufacturers.

We’ve reported on some of those ties in our series, Dollars for

Docs. In particular, we highlighted the case of a

psychiatrist who

served Chicago-area nursing homes and made nearly a half

million dollars promoting AstraZeneca’s best-selling

antipsychotic.

Follow on Twitter: @mariancw

[Guest guest]

Highlighting Drug Industry

Influence, Watchdog Says Overmedication in Nursing Homes Is

Troubling

by n

Wang

ProPublica, May 10, 2011, 2:16 p.m.

Nursing homes are unnecessarily administering powerful

antipsychotic drugs to many elderly residents, including

residents with dementia, according to a new report by the

Health and Human Services inspector general.

The Food and Drug Administration in 2005 mandated that drug

makers issue

warning labels on atypical antipsychotics, noting that the

drugs—which are generally FDA-approved for treating

schizophrenia and bipolar disorder—increase the risk of death

for elderly patients with dementia. 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.

Latest Episode: ProPublica’s Jake Bernstein and

Eisinger give us a behind-the-scenes look at their

Pulitzer prize-winning series, “The Wall Street Money

Machine.”

Listen

»

Doctors and nursing homes aren’t the only ones to blame,

according to HHS Inspector General Levinson. The report

itself does not specifically examine ties between doctors,

pharmacies, and nursing homes, but in a statement

accompanying the report, Levinson faulted drug companies for

aggressively—and illegally—marketing these products to doctors for

treatment of dementia and other off-label uses. (It’s not illegal

for doctors to prescribe drugs for off-label uses, but it is for

drug companies to promote them as such.)

“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,” Levinson

said.

He noted that a number of drug companies have been accused of

illegally promoting these drugs off-label to doctors and

pharmacies, including those that serve nursing home residents.

Some of the lawsuits have settled, but Levin said those

settlements alone don’t negate the effects of years of off-label

promotion.

“Money can't make up for years of corporate campaigns that market

drugs with questionable benefits and potentially deadly side

effects for vulnerable, elderly patients,” according to Levinson.

The report also faulted the Center for Medicare and Medicaid

Services (CMS), the agency that oversees Medicare and Medicaid,

for failing to hold nursing homes accountable for unnecessary use

of antipsychotic drugs. Unnecessary uses can include inadequate

rationale for using the drug as well as excessive doses, excessive

duration, and inadequate monitoring of patients to whom the drug

was given.

The report notes that the federal government paid more than $116

million for claims that violated Medicare reimbursement criteria.

These claims were only for the first half of 2007.

The inspector general recommends that CMS assess its safeguards

for preventing unnecessary antipsychotic drug use in nursing

homes. The agency acknowledged that better controls were needed.

In a letter to the inspector general, CMS Administrator

Berwick wrote that the agency is “very concerned about the nature

of the contractual arrangements” involving nursing homes, the

doctors and pharmacies that serve them, and pharmaceutical

manufacturers.

We’ve reported on some of those ties in our series, Dollars for

Docs. In particular, we highlighted the case of a

psychiatrist who

served Chicago-area nursing homes and made nearly a half

million dollars promoting AstraZeneca’s best-selling

antipsychotic.

Follow on Twitter: @mariancw

[Guest guest]

Highlighting Drug Industry

Influence, Watchdog Says Overmedication in Nursing Homes Is

Troubling

by n

Wang

ProPublica, May 10, 2011, 2:16 p.m.

Nursing homes are unnecessarily administering powerful

antipsychotic drugs to many elderly residents, including

residents with dementia, according to a new report by the

Health and Human Services inspector general.

The Food and Drug Administration in 2005 mandated that drug

makers issue

warning labels on atypical antipsychotics, noting that the

drugs—which are generally FDA-approved for treating

schizophrenia and bipolar disorder—increase the risk of death

for elderly patients with dementia. 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.

Latest Episode: ProPublica’s Jake Bernstein and

Eisinger give us a behind-the-scenes look at their

Pulitzer prize-winning series, “The Wall Street Money

Machine.”

Listen

»

Doctors and nursing homes aren’t the only ones to blame,

according to HHS Inspector General Levinson. The report

itself does not specifically examine ties between doctors,

pharmacies, and nursing homes, but in a statement

accompanying the report, Levinson faulted drug companies for

aggressively—and illegally—marketing these products to doctors for

treatment of dementia and other off-label uses. (It’s not illegal

for doctors to prescribe drugs for off-label uses, but it is for

drug companies to promote them as such.)

“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,” Levinson

said.

He noted that a number of drug companies have been accused of

illegally promoting these drugs off-label to doctors and

pharmacies, including those that serve nursing home residents.

Some of the lawsuits have settled, but Levin said those

settlements alone don’t negate the effects of years of off-label

promotion.

“Money can't make up for years of corporate campaigns that market

drugs with questionable benefits and potentially deadly side

effects for vulnerable, elderly patients,” according to Levinson.

The report also faulted the Center for Medicare and Medicaid

Services (CMS), the agency that oversees Medicare and Medicaid,

for failing to hold nursing homes accountable for unnecessary use

of antipsychotic drugs. Unnecessary uses can include inadequate

rationale for using the drug as well as excessive doses, excessive

duration, and inadequate monitoring of patients to whom the drug

was given.

The report notes that the federal government paid more than $116

million for claims that violated Medicare reimbursement criteria.

These claims were only for the first half of 2007.

The inspector general recommends that CMS assess its safeguards

for preventing unnecessary antipsychotic drug use in nursing

homes. The agency acknowledged that better controls were needed.

In a letter to the inspector general, CMS Administrator

Berwick wrote that the agency is “very concerned about the nature

of the contractual arrangements” involving nursing homes, the

doctors and pharmacies that serve them, and pharmaceutical

manufacturers.

We’ve reported on some of those ties in our series, Dollars for

Docs. In particular, we highlighted the case of a

psychiatrist who

served Chicago-area nursing homes and made nearly a half

million dollars promoting AstraZeneca’s best-selling

antipsychotic.

Follow on Twitter: @mariancw