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Nursing Home Residents Receive Powerful Antipsychotic Drugs for Off-label Uses, Inspector General Report Shows
United States Senate
WASHINGTON – Sen. Chuck Grassley of Iowa and Sen. Herb Kohl of Wisconsin wrote to the administrator of the Centers for Medicare and Medicaid Services in response to a new report showing that 88 percent of the powerful antipsychotic drugs being prescribed to nursing home residents with dementia were for uses that have not been approved by the Food and Drug Administration.
“Nursing home residents are getting antipsychotic drugs for dementia, not psychoses,” Grassley said. “No one seems to have a good handle on whether the patients are benefiting from these medicines or whether they’re being prescribed drugs that don’t help and might even harm them. The government needs to do a better job of protecting nursing home residents from unnecessary drugs. I’ll continue to work to hold the Medicare program and nursing homes accountable for the quality of care delivered to nursing home patients.”
“Late last year we convened a panel of national experts on Alzheimer’s and they told us that we must do a better job of providing care to the rapidly growing number of elders with dementia who live in our nation’s nursing homes,” Kohl said. “As these experts told us, and as the HHS OIG report confirms, Alzheimer’s patients who do not have a diagnosis of psychosis can be seriously harmed by this class of drugs. CMS must find ways to encourage the medical community to use appropriate non-pharmacological treatments for these patients, who deserve to lead dignified lives.”
Grassley and Kohl commented on a report issued by the Department of Health and Human Services Office of Inspector General. The report titled, “Medicare Atypical Antipsychotic Drug Claims for Elderly Nursing Home Residents,” was requested by Grassley in December 2007.
The Inspector General found that 88 percent of the powerful antipsychotic drugs being prescribed to nursing home residents with dementia were for uses that have not been approved by the Food and Drug Administration, even though the drug labels contain “black box warnings” of an increased risk of death in elderly patients with dementia. The report also shows that 22 percent of the nursing homes failed to meet federal standards on unnecessary drug use in nursing homes. Further, more than half of the claims for atypical antipsychotic drugs were improperly paid.
Grassley and Kohl wrote to the administrator of the Centers for Medicare and Medicaid Services, seeking a description of the agency’s actions to protect nursing home residents from unnecessary off-label antipsychotic prescriptions and to protect the taxpayers from improper payments for these drugs. The text of their letter is available here. The text of the report is available here.
Grassley and Kohl have long worked together to safeguard nursing home residents and more broadly, to inject transparency into the financial relationships between drug makers and doctors. Last year, their Physician Payments Sunshine Act became law and will require, beginning in 2013, the Department of Health and Human Services to post on a public website newly reported payments that drug, device and biologic makers make to physicians.