Is Medicare paying for nursing homes to give patients with dementia powerful, non-approved, and potentially lethal “atypical” anti-psychotic drugs?
According to a recent highly critical report from the Inspector General of the U.S. Department of Health and Human Services, the answer is yes…
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.
Critics say the non-approved use of drugs such as Clozaril, Risperdal, Zyprexa, Symbyax, Seroquel, Invega, Abilify, and Geodon is a form of “chemical restraint” to control difficult patients, regarded by many as nursing home abuse. Others claim that prescribing drugs that the FDA has warned may be deadly to dementia patients is due to illegal drug maker kickback schemes.
In his letter to the senators who requested the audit, Inspector General Daniel Levinson wrote “Government, taxpayers, nursing home residents as well as their families and caregivers should be outraged and seek solutions.”
Outrage is easy. But coming up with a solution is going to be a lot more difficult. Many doctors argue that the risk of prescribing these drugs to patients with severe dementia is mitigated by the relief they provide from agitation. It’s a question of balancing quality of life against the remaining length of life.
Still, the cost of these meds — which only skyrockets within a Medicare system rife with fraud — and the danger that their use can easily become abusive and deadly, means this controversy isn’t going away anytime soon.