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New Brookings Report Reveals Dark Side of Nursing Home Drug Use

Our Chicago nursing home neglect lawyers are encouraged that more and more attention is being focused on an issue that affects thousands of local residents but for far too long went unnoticed: inappropriate nursing home drug use. Last week the Brookings Institute released a comprehensive new report on the subject, “Uncomfortably Numb: The Dark Side of Inappropriate Drug Use in Nursing Homes.” One central feature of the report involves the clear conflicts of interest and skewing of decisions in the long-term care industry based on the financial incentives of those involved. This is particularly true when it comes to the actions of long-term care pharmacies which leads to dangerous and unnecessary drug use in nursing homes-a subtle but prevalent form of nursing home abuse. Beyond placing the lives of these seniors in danger, the conflicts also run up the costs of the Medicare Program. In these times of tight budgets, it is clear that changes need to be made that will both make patients safer and lower costs.

The report found that the risk of drug-induced harm in these homes is at unacceptable levels. Upwards of half of all nursing home residents are given drugs inappropriately. This figure was reached by a U.S. Health and Human Services Office of Inspector General report from earlier this year. That report looked at atypical antipsychotic drug use in homes and found that 51% of those prescriptions to Medicare patients were wrongly prescribed. A staggering eighty three percent of these atypical drug claims were for “off label” reasons, and eighty eight percent were for residents with dementia. This was the case even though, as all nursing home lawyers know, given these drugs to dementia patients come with an increased risk of death. The FDA mandates that this risk be placed on all boxes of the drugs. There is simply no excuse for so many facilities to commit this nursing home neglect by failing to protect these already vulnerable patients from unnecessary drug use.

One of the main reasons why many advocates suspect that the drug problems are so prevalent are the misaligned financial incentives of those doling out the drugs. Certain pharmacies are connected with certain nursing homes. These pharmacies rake in millions every year from taxpayers via use of Medicare Part D for these drug dispensations. Essentially these pharmacies have significant market power, because they control use of 90 percent of the long-term care market share. As a result, they can force pharmaceutical manufacturers to make financial concessions in exchange for “moving” their product.

Not only that, but these pharmaceutical companies employ the pharmacists who serve each nursing home. Those pharmacists are involved in making recommendations about what drugs a patient should receive. In fact, government law requires pharmacy reported to be acted upon by nursing home staff. That means that individual pharmacists are forced to make drug decisions that financially affect his or her employer. This is a situation that cannot stand. It is an untenable conflict which places resident lives at risk and costs taxpayers millions and millions in unnecessary Medicare expenditures.

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