North Carolina appears to be leading the nation in the effort to reduce drug over-prescription abuse in nursing homes. A report released by the Federal Center for Medicare and Medicaid services shows that the rate of antipsychotic drug use in North Carolina has fallen twenty-three percent. Many nursing homes in America prescribe these drugs in order to control and calm their patients. As a side effect, these patients are more likely to fall and can become too drugged to participate in activities they previously enjoyed.

A North Carolina expert says that to offer better treatment and reduce the dependence on these drugs, a well trained staff is essential. They should pay close attention and build strong relationships with the patients. Some alternative treatments include music therapy and massage for agitated patients. Hopefully other states will take notice of North Carolina’s strides towards improving elder care and follow suit with more efforts to reduce the use of unnecessary prescriptions to control patients.  See full article at WUNC.

Alarming new numbers released by the U.S. Centers for Disease Control document a huge rise in opioid pain reliever prescription use over a ten year span. Opioids are a class of drug commonly prescribed for pain-relief that include Dilaudid, Percocet, Hydrocodone, OxyContin, Oxycodone, Vicodin and Morphine. They are classified as highly addictive and can easily become lethal if too much is given. Deaths due to overdoses of prescription opioid drugs rose 415% among women and 265% among men from 1999 to 2010. A Mayo Clinic report shows opioid pain-killers are now ranking among the three most common types of prescriptions given to Americans. It also showed that women and the elderly are more likely to receive more prescriptions than the average person.

The CDC Director cites aggressive and misleading marketing of these drugs aimed at doctors as one reason for the spike in overdose deaths. The CDC urges doctors to take a second look at pain-management strategies for their patients, and consider alternative therapies such as physical therapy and exercise. Leading the way is Washington state, which has successfully worked with prescribers and insurers on better guidelines for opioid prescriptions and has since seen a 23% decrease in opioid-related deaths.
See article from Healthline here.

The San Francisco Chronicle reported Jodi Alexander, an Oklahoma nursing home worker, has been charged in connection with a prescription drug ring.  Alexander is accused of stealing prescription medications from patients at the Crescent Care Center where she worked, changing medical records so they wouldn’t reflect a discrepancy. Alexander and Dale Steven Markus, her boyfriend, were charged with distribution of a controlled dangerous substance. She was also charged with larceny.

The Medicare drug benefit is provided by private insurance companies, competing with one another and operating under contracts with the federal government. Each insurer has one or more committees that decide which drugs will be covered. The decisions are supposed to be based on scientific evidence.

However, the NY Times reported that a new report by Daniel R. Levinson, the inspector general at the Department of Health and Human Services, which admitted that the federal Medicare agency had not clearly defined “conflict of interest” and did not enforce standards meant to prevent such conflicts from influencing drug coverage decisions by the panels, known as pharmacy and therapeutics committees.

“The Centers for Medicare and Medicaid Services does not monitor conflicts of interest on pharmacy and therapeutics committees,” Mr. Levinson said. In many cases, he said, the government cannot identify potential conflicts because committee membership lists are unusable — incomplete, inaccurate and full of discrepancies. The panels are appointed by insurers or pharmaceutical benefit managers hired by insurance companies.

A separate study by university researchers found similar problems in many state Medicaid programs. The study, published this month in the journal JAMA Internal Medicine, described “inadequate management of conflicts of interest” among the panels that recommend drugs for coverage under Medicaid.

Since Medicare officials do not monitor conflicts of interest, Mr. Levinson said, they cannot be sure that prescription drug plans are complying with federal requirements that at least two committee members — one practicing physician and one pharmacist — be “independent and free of conflict.”

 

 

The Washington Post reported that the average premium for basic Medicare drug coverage will stay the same next year, $30 a month. That’s the third year in a row of little or no change. In addition, Medicare recipients with high prescription costs are saving an average of $629 apiece thanks to a provision of the new health care law that gradually eliminates a coverage gap called the “doughnut hole.”

 

Canton Rep reported on Ohio’s attempt to reduce the theft of prescription drugs in nursing homes and assisted living facilities. The attempt is one of several state initiatives aimed at reducing the abuse of prescription painkillers, which has led to record numbers of accidental overdose deaths in Ohio.  Another proposal targets emergency room doctors and their role in the large numbers of prescription painkillers disbursed in the state.

 

A nursing home in Oklahoma is at the center of a drug ring involving residents’ prescription medications.  Director of Nursing Jackie Allen Alexander and Melanie A. Kirby, the assistant director of nursing were arrested on charges for multiple counts of obtaining controlled substances by fraud or forgery, conspiracy to obtain and conspiracy to distribute.  Prosecutors have filed drug-related charges against six employees at Callaway Nursing Home. The Oklahoma Bureau of Narcotics says the employees are accused of calling in fraudulent prescriptions to pharmacies to obtain painkillers, including hydrocodone.  The drugs were later sold on the street.

An audit showed more than 9,000 dosage units of controlled substances had been diverted by employees, said Mark Woodward, Oklahoma Bureau of Narcotics spokesman. More than 8,400 of the dosage units involved the pain medication hydrocodone.

 

Reuters Health reported an interesting article on U.S. Food and Drug Administration (FDA) recalls.  Every month the FDA recalls potentially harmful drugs but the information is not getting to doctors and patients according to a new study in the Archives of Internal Medicine.

Researchers found that the FDA failed to send notifications for one in five of the most serious recalls. These so called Class I recalls are issued for drugs that, if taken, have the potential to cause “serious adverse health consequences or death.”

Why don’t drug companies send letters directly to doctors?

 

The Washington Post reported the White House were tough negotiators with drug industry executives to get a 2009 deal that helped keep health care overhaul legislation from bogging down in Congress.  Internal emails obtained from the industry by the House Energy and Commerce Committee shed light on the negotiations.  The drug industry’s $80 billion commitment gave Obama some momentum at a time when health care overhaul appeared to be bogging down on Capitol Hill. Drug makers agreed to help close Medicare’s prescription coverage gap, known as the “doughnut hole,” and to make other financial contributions.

The emails reveal the distrust among participants, bitter rivalries among insurers, drug makers and hospital groups, and high anxiety on all sides about the progress of the legislation.

 

USA Today reported that "almost 4 million seniors saved about $2.16 billion through discounts for their prescription medications in 2011", according to the Department of Health and Human Services.  "The 2010 health care law required a 50% discount on prescription drugs in the so-called doughnut hole, or the gap between traditional and catastrophic coverage in the Medicare drug benefit, also known as Part D. In 2012, the coverage gap is $2,930. The Affordable Care Act eliminates the doughnut hole by 2020." 

In 2010, Medicare sent $250 rebate checks — totaling $846 million — to nearly 3.8 million seniors to try to counterbalance the gap. In the first two months of 2012, about 100,000 people have received $92.7 million in discounts — about $904 per person

Government costs for prescription medications through Medicare should decrease after seniors saved more than $2 billion in 2011 through discounts offered by the program. When Medicare recipients are able to take their medications, they are hospitalized less often for heart attacks, low blood sugar and asthma attacks thus reducing long term health care costs.

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