The New York Times reported that Federal investigators say they have found evidence of widespread overuse of psychiatric drugs by older Americans with Alzheimer’s disease, and are recommending that Medicare officials take immediate action to reduce unnecessary prescriptions. Experts have raised concern about the use of antipsychotic drugs to address behavioral symptoms of Alzheimer’s and other forms of dementia. The Food and Drug Administration says antipsychotic drugs are often associated with an increased risk of death when used to treat older adults with dementia who also have psychosis. Antipsychotic drugs are expensive, costing hundreds of millions of Medicare dollars. They also increase the risk of death, falls with fractures, hospitalizations and other complications.
The findings by the Government Accountability Office, said officials needed to focus on overuse of such drugs by people with dementia who live at home or in assisted living facilities. The Department of Health and Human Services “has taken little action” to reduce the use of antipsychotic drugs by older adults living outside nursing homes, the report said. Doctors sometimes prescribe antipsychotic drugs to calm patients with dementia –often in nursing homes that had inadequate numbers of employees.
Senator Susan Collins, Republican of Maine and chairwoman of the Senate Special Committee on Aging, who with Mr. Carper requested the study, said, “The report raises many red flags concerning the potential misuse and excessive use of antipsychotic drugs for patients with Alzheimer’s and other dementias.”
Toby S. Edelman, who represents patients as a lawyer at the Center for Medicare Advocacy, said, “We could save money and provide better care if nursing homes reduced the inappropriate use of antipsychotic drugs.”
A Chicago psychiatrist pleaded guilty last month to taking illegal kickbacks of nearly $600,000 to prescribe an antipsychotic drug for his patients. The doctor, Michael J. Reinstein, also agreed to pay $3.79 million to the federal government and the State of Illinois to settle a lawsuit asserting that he had been involved in the submission of at least 140,000 false claims to Medicare and Medicaid. Law enforcement officials said he had prescribed clozapine for thousands of older and indigent mentally ill patients at 30 nursing homes and other sites. The lawsuit said drug companies had paid kickbacks, consulting fees and entertainment expenses for Dr. Reinstein as part of an effort to induce him to write prescriptions for clozapine. Last March, Teva Pharmaceuticals Industries and a subsidiary, IVAX Pharmaceuticals, agreed to pay $27.6 million to settle allegations that they had violated federal and state False Claims Acts by making payments to Dr. Reinstein.