Regulation Proposed For Over Prescribing Elderly
The practice of overly prescribing nursing homes patients has finally caught the attention of regulators and authorities. Elderly people with dementia (a condition known in the insurance world as “off-label”) are often prescribed powerful antipsychotic drugs to keep them quiet, and Medicare picks up the bill—even though Medicare guidelines don’t permit off-label prescription reimbursements. Dementia is separate from Alzheimer’s and other more serious degenerative diseases; it’s akin to senility.
Over prescribing off-label drugs is dangerous for patients and costly for taxpayers. A report from the Inspector General’s office in 2012 found that 83% of Medicare claims for antipsychotic drugs prescribed to nursing home patients were for off-label conditions. Prescribing antipsychotic medication for off-label conditions has not been approved by the FDA—but is still practiced by 23.9% of nursing homes in the U.S. Three of the most commonly prescribed antipsychotics are Quentiapine, Olanzapine, and Risperidone; all of these cause excessive sedation and unresponsiveness, and they increase the risk of strokes (and premature death) in elderly patients.
At a recent press conference, government authorities introduced a bill to reduce the over-prescription of off-label drugs; the bill requires the patient’s family members’ consent before the drugs are prescribed. The legislation also includes resources to train, educate, and alert caregivers and health care professionals about over-prescription. At the same conference, advocates for the elderly announced the formation of a statewide coalition, designed to reduce off-label antipsychotic drug usage in geriatric medicine. Called the Partnership to Improve Dementia Care in Nursing Homes, the coalition is working to increase awareness of over-prescription in the elderly.
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