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Big Pharma's Role In Overmedicating Nursing Home Patients Noted In Government Report


First Posted: 05/10/11 01:27 PM ET Updated: 07/10/11 06:12 AM ET

Welcome to "The Watchdog," which will keep a close eye on regulatory agencies and how their actions impact the lives of everyday Americans. Though the rules and regulations they write -- from determining how much arsenic is allowable in your drinking water to whether your favorite TV show can drop the F-bomb in primetime -- affect all of us, their deliberations and the way that lobbyists influence their decisions receive very little coverage. To make sense of these debates, follow the implementation of health care and financial reform and decipher the minutia of the Federal Register, "The Watchdog" is on the case. If you have any tips, send them to marcus@huffingtonpost.com.

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Hundreds of thousands of elderly nursing home residents suffering from dementia may have been overmedicated with strong anti-psychotic drugs that could harm them, according to a new report from the Department of Health and Human Services.

Almost 90 percent of 300,000 nursing home residents with dementia got powerful drugs meant for treating serious mental illnesses like schizophrenia and bipolar disorder in 2007, says Health and Human Services Inspector General Daniel R. Levinson.

In an alarming statement, Levinson noted the complicity of drug companies in this dangerous practice:

"Despite the fact that it is potentially lethal to prescribe antipsychotics to patients with dementia, there's ample evidence that some drug companies aggressively marketed their products towards such populations, putting profits before safety...

The report didn't explore this issue, but a series of lawsuits and settlements that DHHS helped bring about suggest that many pharmaceutical companies have improperly promoted these drugs to doctors and nursing homes for many years.

For example, Eli Lilly pled guilty to criminal charges associated with illegally marketing its drug Zyprexa (olanzapine), including to doctors that treat elderly nursing home patients. Several other pharmaceutical companies -- Bristol-Meyers Squibb, Astra Zeneca and Pfizer -- settled government allegations that they improperly promoted their antipsychotic drugs for unapproved uses. Federal prosecution is pending against Johnson & Johnson for allegedly paying millions of dollars in kickbacks to induce Omnicare, the nation's largest long-term care pharmacy, to recommend the use of Risperdal in treating nursing home patients, many of whom had dementia."

The agency initiated the report when a member of Congress questioned how many nursing home residents received a class of antipsychotic drugs introduced in the 1990s, among them risperidone and olanzapine. "These drugs, known as "atypical" or "second generation" antipsychotics, replaced (at much higher cost) antipsychotic drugs introduced in the 1950s and 1960s to treat schizophrenia," adds the report.

In addition, the IG found that for one in five residents, nursing homes dispensed these drugs in a way that violated the government's standards for their use -- for example, the prescribed dose was too high or residents were on medication for too long.

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The natural gas drilling boom across the country has raised concerns about hydraulic fracturing, or fracking, the controversial process used during natural gas drilling that has been linked to poisoned drinking water, polluted air and explosions.

Last month, the folks at Earth Justice produced an interactive map of “fraccidents” from California to Pennsylvania. Check it out here.

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• The mining industry, under increased scrutiny a year after the deadliest U.S. mine accident in decades, is asking the government for a more cooperative form of regulation that would allow some mines to avoid regular inspections, reports the Center for Public Integrity.

• Florida could become the first state in the nation to bar doctors from asking parents and other patients if they have guns in their homes, a measure that opponents say endangers children and adolescents.

• Today's the deadline for comments on the Office of Thrift Supervision’s proposal to modify how risk-based capital requirements are calculated. OTS wants a minimum Tier I risk-based capital ratio of 4 percent and total ratio of 8 percent.

• The Food and Drug Administration issues two new regulations, the first to be issued by the agency under the Food Safety Modernization Act. One regulation allows the FDA to detain food believed to have been produced in unsanitary or unsafe conditions, and the other requires anyone importing food into the country to inform the FDA if any country has refused entry to the same product.

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