The Inspector General for the Department of Health and Human Services has found that one out of seven nursing home patients with dementia were wrongfully administered potentially lethal antipsychotic drugs.
Some are blaming Medicare oversight, although the Centers for Medicare and Medicaid Services are blaming pharmaceutical companies, who they claim received kickbacks off of the practice. Meanwhile, the FDA maintains it has warned doctors of the prohibitive risks involved, but some doctors claim that in the absence of a better solution, antipsychotics are at least useful for raising the quality of a patient's life, albeit potentially cutting it short.
Perhaps where the blame lies is secondary to the problem itself. According to the FDA, using powerful antipsychotic drugs on elderly patients with dementia increases the risk of death. These treatments have not been federally approved. Medicare, however, does not necessarily view diagnoses before approving drug claims, so it eventually approved $116 million of these erroneous claims in the first half of 2007. This accounts for over half of the antipsychotics that were approved by the organization at the time (51%).
According to the N.Y. Times: "The auditors found that 83 percent of antipsychotic prescriptions for elderly nursing home residents were for uses not approved by federal drug regulators, and 88 percent were to treat patients with dementia — for whom the drugs can be lethal." Furthermore, there is a second layer of regulation, preventing excessive doses of "inappropriate" drugs, but "[a]uditors found that 22 percent… of 1.4 million claims, for antipsychotic medicines failed this standard."
Sen. Chuck Grassley (R-IA), who called for the audit, believes "these results are alarming" and that "Medicare officials need to pay attention."
As should the medical malpractice community.
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