CCHR International » Charles Grassley

1 out of every 7 Elderly Nursing Home Residents on Antipsychotics—Despite Risk of Death

admin — Mon, 18 Jul 2011 17:37:20 +0000

Modern Medicine – July 16, 2011

Long-term-care (LTC) facilities are overusing antipsychotic drugs. One of every 7 elderly nursing home residents is receiving at least 1 atypical antipsychotic; in 83% of these cases, the drug is associated with a dementia diagnosis, yet the use of atypical antipsychotics in dementia increases the risk of death and is not approved by FDA, according to a report from the Office of the Inspector General (OIG).

Erroneous claims

“Government, taxpayers, nursing home residents, as well as their families and caregivers, should be outraged — and seek solutions,” said Daniel R. Levinson, Inspector General, Department of Health and Human Services (HHS), in a statement. “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 toward such populations, putting profits before safety.”

OIG analyzed atypical antipsychotic use in LTC at the request of Sen Charles Grassley (R-Iowa). The report, issued in May, evaluated Part B and Part D claims data from January to June 2007. Analysts concluded that 51% of Medicare claims for atypical antipsychotics were erroneous. The claimed drugs were not used for medically accepted indications, not used off label as supported by recognized compendia, or not documented as having been administered to the elderly nursing home resident. The erroneous payments totaled $116 million for the 6 months studied.

Unmet standards

OIG also found that 22% of atypical antipsychotics used in LTC were not administered according to Medicare standards regarding unnecessary drug use in nursing homes. The standards are designed to reduce excessive dosage, excessive duration of therapy, inappropriate use, and lack of appropriate monitoring. Noting that violation of unnecessary drug-use rules may affect nursing homes’ participation in Medicare, OIG recommended that HHS act to reduce unnecessary drug use in LTC.

The report included aripiprazole (Abilify, Bristol-Myers Squibb), clozapine (Clozaril, Novartis), olanzapine (Zyprexa, Eli Lilly), olanzapine/fluoxetine (Symbyax, Eli Lilly), paliperidone (Invega, Janssen), quetiapine (Seroquel, AstraZeneca), risperidone (Risperdal, Janssen), and ziprasidone HCl (Geodon, Pfizer).

http://drugtopics.modernmedicine.com/drugtopics/Modern+Medicine+Now/Antipsychotics-overused-in-LTC-setting-OIG-says/ArticleStandard/Article/detail/730695

« Return to news items

News Feed

Grassley Investigates Drugging of Elderly with Antipsychotics

cchrint — Wed, 01 Jun 2011 17:37:35 +0000

DesMoines Register
May 31, 2011

Sen. Charles Grassley recently sent a letter to the administrator of the U.S. Centers for Medicare and Medicaid Services. He wants some answers after a federal report Grassley requested found many nursing home residents with dementia are given antipsychotic drugs. These drugs are not approved to treat dementia. They can be lethal for those afflicted with it, and Medicare has been paying for them.

Grassley is right to ask questions of the agency. But keeping seniors safe is a responsibility that extends far beyond CMS — from the halls of Congress to state legislatures to nursing home workers in rural Iowa.

Washington

Politicians talk out of both sides of their mouths. They say they want to cut federal spending. They say there should be less government regulation. Then when something goes wrong, they demand federal agencies solve the problems or they take them to task for not doing what they were supposed to do.

Drug safety, nursing home oversight, and ferreting out problems in government programs like Medicare requires staff and resources. That takes money – some of the same money lawmakers propose cutting from the federal budget.

State legislatures

The “cut government but still expect it to keep everyone safe” attitude is prevalent at the state level, too. Shortly after Gov. Terry Branstad took office, one of his appointees cut positions for nursing home inspectors. It underscored a lack of understanding about the important and complicated work of making sure homes meet more than 150 regulatory standards.

In addition to observing care, talking to staff, interviewing residents and other tasks, an inspection team reviews medical records. It is frequently a registered nurse employed by the state who finds problems with medications. Having too few state inspectors puts seniors at risk.

Nursing homes and staff

Improving the quality of life for patients with dementia is difficult — and there are too few drugs approved specifically to do so. Even if doctors are aware of the risks, they may prescribe specific drugs to make patients more comfortable or less agitated. Also, drug companies benefit when more people take their drugs, and they want doctors to prescribe their drugs to, well, as many people as possible. In fact, several drug companies have faced criminal charges for promoting antipsychotic drugs for unapproved uses.

It’s up to nursing home staff and physicians to ensure that drugs prescribed are safe for specific patients.

* * *

Every day about 10,000 Americans become eligible for Medicare. An aging population means more people will be diagnosed with dementia. More will need care in facilities. Everyone — from doctors prescribing drugs to the government paying for them — must do more to keep older people safe.

Read article here: http://www.desmoinesregister.com/article/20110601/OPINION03/106010328/-1/GETPUBLISHED03wp-rss2.php/More-need-help-protect-our-elderly

« Return to news items

News Feed

Top prescribers under Senate’s microscope

cchrint — Mon, 25 Oct 2010 16:40:16 +0000

U.S. Sen Charles Grassley, R-Iowa, examined Minnesota doctors as part of his investigation into the overprescription of drugs, at great cost to Medicaid and Medicare.

Star Tribune
By Jeremy Olson
October 25, 2010

Minnesota doctors are again under the microscope of an influential U.S. senator from Iowa — this time because of concerns that expensive medications are being overprescribed at great cost to the publicly funded Medicaid and Medicare programs.

U.S. Sen. Charles Grassley, R-Iowa, notified federal authorities Wednesday that he found potential examples of overprescribing after requesting lists from states, including Minnesota, of doctors who issued the most prescriptions for antipsychotic and narcotic medications in 2008 and 2009.

The most egregious example, cited in a letter to Health and Human Services Secretary Kathleen Sebelius, was a Florida doctor who wrote 96,685 prescriptions for mental health drugs in 21 months and billed the cost to the state’s Medicaid program.

Grassley’s letter mentioned no Minnesota physicians, instead pointing out doctors in Ohio, Oklahoma and South Dakota who prescribed many more high-cost drugs than their colleagues to poor and disabled Medicaid patients.

Grassley’s findings don’t prove fraud or overprescribing, but they could cause doctors to be removed from participating in Medicare and Medicaid, government health programs that, between them, insure some 100 million elderly, poor and disabled Americans. He urged federal authorities to pick up the trail.

“This trend is found again and again across the states,” Grassley wrote, “suggesting that top prescribers stand out not only against other providers in their state, but against the very top prescribers in those states.”

Last April, Grassley asked Minnesota authorities for a list of 10 doctors who submitted the most claims to the Department of Human Services for prescriptions of such specific antipsychotics as Seroquel and such narcotics as OxyContin.

The state provided the information in May. It also conducted its own review to determine whether the prescriptions appeared appropriate, and whether the top prescribers of antipsychotics were in appropriate specialties, such as psychiatry.

A department spokeswoman said no formal investigations were launched as a result of the review.

None of the doctors on the Minnesota list appeared to approach the excesses Grassley highlighted in other states. Several are on staff at rural mental health centers, which puts them in a position to issue more prescriptions.

Roseville psychiatrist Dr. Roger Johnson stood out on the list, issuing 1,605 prescriptions for Seroquel to patients in Minnesota’s managed-care and fee-for-service Medicaid programs in 2009 — up from 916 prescriptions in 2008. Documents show that his claims to the fee-for-service program alone approached $450,000 last year. The next closest doctor billed the state for just 688 Seroquel prescriptions last year.

Read entire article here: http://www.startribune.com/lifestyle/health/105576013.html?page=2&c=y

« Return to news items

News Feed

Pfizer Makes Bank from DrugsThat Can Kill You—To say Pfizers been accused of wrongdoing is like saying BP had an oil spill

cchrint — Mon, 12 Jul 2010 16:25:52 +0000

AlterNet
By Martha Rosenberg
July 10, 2010

The drug company Pfizer is best known for Lipitor, a drug that brings cholesterol down and Viagra, a drug that brings other things up.

But the “world’s largest research-based pharmaceutical company” which sits between Goldman Sachs and Marathon Oil on the Fortune 500, is also closely associated with a seemingly never-ending series of scandals.

To say Pfizer’s been accused of wrongdoing is like saying BP had an oil spill. Other drug companies have a portfolio of products, Pfizer has a portfolio of scandals including, but not limited to, Chantix, Lipitor, Viagra, Geodon, Trovan, Bextra, Celebrex, Lyrica, Zoloft, Halcion and drugs for osteoarthritis, Parkinson’s disease, kidney transplants and leukemia.

During one week in June Pfizer 1) agreed to pull its 10-year-old leukemia drug Mylotarg from the market because it caused more, not less patient deaths 2) Suspended pediatric trials of Geodon two months after the FDA said children were being overdosed 3) Suspended trials of tanezumab, an osteoarthritis pain drug, because patients got worse not better, some needing joint replacements (pattern, anyone?) 4) Was investigated by the House for off-label marketing of kidney transplant drug Rapamune and targeting African-Americans 5) Saw a researcher who helped established its Bextra, Celebrex and Lyrica as effective pain meds, Scott S Reuben, MD, trotted off to prison for research fraud 6) was sued by Blue Cross Blue Shield to recoup money it overpaid for Bextra and other drugs 7) received a letter from Sen. Charles Grassley (R-Iowa) requesting its whistleblower policy and 8 ) had its appeal to end lawsuits by Nigerian families who accuse it of illegal trials of the antibiotic Trovan in which 11 children died, rejected by the Supreme Court. And how was your week?

Nor does Pfizer back down when faced with legal troubles.

Even as it was under the probation of a 5-year Corporate Integrity Agreement (CIA) with Health and Human Services for withholding $20 million in Lipitor rebates owed to Medicaid in 2002, it off-label marketed its seizure drug Neurontin and entered into another CIA in 2004.

Read entire article: http://www.alternet.org/story/147467/

« Return to news items

News Feed

Senator Grassley Investigates Big Pharma’s Treatment of Drug Company Whistleblowers Who File Complaints

cchrint — Thu, 01 Jul 2010 18:26:30 +0000

Bloomberg
By David Voreacos
July 1, 2010

U.S. Senator Charles Grassley asked 16 drugmakers, including Pfizer Inc., AstraZeneca Plc and Eli Lilly & Co., to reveal how they treat whistleblowers who file complaints under the False Claims Act.

Grassley, an Iowa Republican, sent letters June 28 that posed eight questions such as how companies notify employees of the law, how they treat whistleblowers and what changes they have made in response to a 2009 law extending anti-retaliation protections. Grassley’s office provided copies of the letters.

The False Claims Act lets private citizens sue on behalf of the government and share in any recovery. Whistleblowers were paid $2.39 billion from 1987 to 2009, or 16 percent of the $15.19 billion collected in False Claims lawsuits in which the U.S. government joined the case, according to the Justice Department.

“What measures does Pfizer have in place to ensure fair treatment to those filing complaints?” Grassley wrote to Chief Executive Officer Jeffrey Kindler. “Of employees who have filed complaints, have any complained of unfair treatment and/or retaliation after the filing of the complaint?”

The False Claims Act was passed by Congress in 1863 and strengthened three times since 1986. Citizens file so-called qui tam cases that remain sealed from public view as the Justice Department investigates the claims and decides whether to join the suit. Twenty-five U.S. states have their own versions of the law.

Large Settlements

Drugmakers have reached some of the largest settlements in recent years. Pfizer agreed to pay $2.3 billion over improper drug marketing, Lilly paid more than $1.6 billion to settle claims over its marketing of the drug Zyprexa, and AstraZeneca paid $520 million over marketing of its drug Seroquel.

Read entire article: http://www.bloomberg.com/news/2010-06-30/grassley-seeks-data-from-pfizer-lilly-on-how-whistleblowers-are-treated.html

By David Voreacos

« Return to news items

News Feed

Say what? Psychiatrist Charles Nemeroff who failed to report $1.2 mil in Pharma deals lands psych chairmanship at University

cchrint — Thu, 05 Nov 2009 23:17:40 +0000

John Dorschner
The Miami Herald
November 5, 2009

Charles Nemeroff, an Atlanta psychiatrist who was the subject of a Senate investigation concerning huge sums he received from drug companies, is being named chair of the psychiatry department at the University of Miami medical school.

Last year Nemeroff, as chair of the Department of Psychiatry at Emory University, was the intense focus of an investigation by Sen. Charles Grassley, R-Iowa, who said he was concerned about the money the psychiatrist received from drug companies while conducting supposedly unbiased research for the National Institutes of Health on drugs made by the companies he was receiving money from.

On Thursday, Pascal Goldschmidt, dean of UM medical school, called Nemeroff “an extraordinary psychiatrist and scientist. . . . He got into serious trouble on disclosure on conflict of interest.”

Goldschmidt said he had read investigative reports from Emory about Nemeroff’s activities and found nothing to indicate that payments the psychiatrist received had in any way influenced his research results.

In a telephone interview at mid-day Thursday, Nemeroff, 60, told The Miami Herald he was excited to be coming to Miami. “I think it’s going to be a top-10 school.”

A front-page report by The New York Times in October 2008 said that congressional investigators found Nemeroff — “one of the nation’s most influential psychiatrists” — had received $2.8 million in consulting deals with drug makers over seven years and failed to report at least $1.2 million of that to Emery University.

Read entire article: http://www.miamiherald.com/news/breaking-news/story/1318257.html

« Return to news items

News Feed

Psychiatrist exposed in Grassley investigation resigns after failing to report hundreds of thousands in Pharma funds

cchrint — Mon, 02 Nov 2009 21:42:31 +0000

Bob Grant
TheScientist.com
November 2, 2009

The Emory University psychiatry researcher who failed to report hundreds of thousands of dollars in pharmaceutical company payouts while receiving millions of dollars in funding from the National Institutes of Health to study the company’s anti-depressant drugs is leaving the university, according to the Atlanta Journal Constitution.

Charles Nemeroff, a renowned depression researcher, failed to disclose to Emory approximately $800,000 in payments he received from drug maker GlaxoSmithKline (GSK) while he was the principal investigator (PI) on a multi-million dollar grant from the NIH to study five GSK antidepressants. Amid an investigation conducted by Emory, Nemeroff stepped down from his position as chairman of the psychiatry department last October. Later that month, the psychiatrist stepped down as PI from the $9.3 million NIH grant as the Senate probed his failure to disclose income from GSK, and the NIH froze funding on the five-year grant.

Read entire article: http://www.the-scientist.com/blog/display/56127/

« Return to news items

News Feed

Congressman Ron Paul’s Parental Consent Act

admin — Thu, 15 Oct 2009 00:49:31 +0000

By John Breeding
Psychologist, Author, The Wildest Colts Make the Best Horses
October 14, 2009

On April 30, 2009, Congressman Ron Paul introduced H.R. 2218, known as The Parental Consent Act of 2009.

The bill forbids federal funding for universal or mandatory mental health screening, and also forbids money for any educational or other government agency that would use a parent’s refusal to consent to their child’s screening as basis for a charge of child neglect or abuse.

Click here for video interview with Kent Snyder, Ron Paul’s Presidential Campaign Manager, speaking about why Congressman Paul introduced the Parental Consent Act.

A little recent history is relevant. On April 29, 2002, President George Bush created the New Freedom Commission on Mental Health. In 2003, this industry-studded commission presented their recommendations for the reform of the United States mental health system.

“To aid in transforming the system,” the authors of the report wanted to do many things, including:

Improve and expand school mental health programs.
Screen for co-occurring mental and substance use disorders and link with integrated treatment strategies.
Screen for mental disorders in primary health care, across the lifespan, and connect to treatment and supports.

This rhetoric serves to hide the truth that New Freedom is better called No Freedom or New Intrusion, and that mental health screening really means mass marketing and target recruitment of a captive population.

By the time of these New Freedom Commission recommendations, there already existed very large numbers of citizens around the country wising up to the extraordinary intrusion of psychiatry into our schools, as demonstrated in the first four years of this millennium by a number of resolutions, education department statements and state laws, all defending a parent’s right to make treatment decisions for a child without coercion, and a child’s right to education without psychiatric labeling and drugs.

Through 2003, there had been at least 46 state bills or resolutions supporting parental choice, in 28 states, that had either passed or were still pending action across the United States. For example, Connecticut, Minnesota and Texas had passed laws explicitly stating that a parent’s refusal to consent to the administration of a psychotropic drug to a child does not constitute neglect, therefore is not in itself grounds for Child Protective Services (CPS) investigation. Other states have passed related laws either monitoring or curbing CPS policy in this area.

Many states are pursuing related legislation as the wave of activity in support of parental choice continues to expand. Texas law now prohibits school personnel from suggesting a diagnosis or recommending a psychotropic drug to a parent for their child. The public will is clearly for the schools to educate, not medicate, and for the state to allow privacy and autonomy to parents and families. At a federal level the fight over the Child Medication Safety Act was eventually won so that nowhere in the country is it legal to require a psychiatric controlled substance as a condition of attending school.

Ron Paul has been a key leader in this effort for some time. On October 6, 2004, he introduced an earlier incarnation of his current Parental Consent Act. This one, aptly titled the Let Parents Raise Their Kids Act, also attempted to forbid federal funds from being used for any universal or mandatory mental-health screening of students without the express, written, voluntary, informed consent of their parents or legal guardians.

Since that time, the fight has only intensified. In 2005 in Texas, for example, we fought tooth and nail to the bitter end to defeat a bill that would have initiated mental health screening in schools throughout Texas. Since we have defeated them consistently, this session they tried to get a pilot program approved for San Antonio and we defeated that as well, but the psychiatric and pharmaceutical lobbies are relentless. PsychSearch.net provides one of the best websites on mental health screening and the ongoing resistance.

We have been aided by our awareness. Made possible largely by the work of Pennsylvania whistleblower Allen Jones, we know that many of the New Freedom commissioners are linked directly or indirectly to the Texas Medication Algorithm Project (TMAP), which provides formulas recommending specific psychotropic drugs to treat various “mental illnesses.” It has been revealed that TMAP pushed an off-label drug marketing scheme that appears to skirt federal law. We know, therefore, that this commission’s recommendations are intended to encourage an expansion of the fact that “appropriate services” in today’s psychiatric world means psychotropic drugs; there are already millions upon millions of school-age children on psychiatric drugs.

Senator Charles Grassley’s work outing the severe ethical financial conflicts of so many psychiatric industry spokespersons makes it a little easier to challenge these things. For example, it tends to impress legislators when they hear that three psychiatry department chairs—Charles Nemeroff of Emory University ($1 million from GlaxoSmithKline alone), Martin Keller of Brown University (associated with a severely compromised drug trial) and Alan Shatzberg of Stanford (who was principal investigator on a drug developed by a company in which he owned $6 million of stock) have all recently resigned their positions as a result of Grassley’s investigation.

The very high number of false positives in mental health screening is good data. In one study at Columbia University, the authors concluded that use of the Columbia Suicide Screen would result in 84 non-suicidal teens being referred for further evaluation for every 16 youths correctly identified. It also helps to know that these type programs tend not to work anyway. For example, the United States Preventive Services Task Force (USPSTF) found that screening for suicide risk does not reduce suicide attempts or mortality.

Finally, the facts about the severe dangers and lack of efficacy of the various types of psychiatric drugs gets attention once the truth is made known.

I consider this to represent a tragic situation, and a clear and present danger to our children. Here is a pledge that thousands specifically signed and that so many more are acting on in the concerted challenges around the country to this scourge:

We promise to actively resist further intrusion of psychiatry into the public schools, and will not cooperate in any way with those who act as agents of this wrong-headed government initiative. We do not now and will not later consent to the psychiatric or psychological testing of our children by those who act as agents to implement New Freedom recommendations for universal mental health screening of our children.

The Parental Consent Act of 2009 is a great idea. Passing this bill in Washington would make a significant difference in protecting children and families against further intrusion of psychiatry into the schools. I know it would also make this Texas activist’s life a little easier!

John Breeding, Ph.D. has been a counseling psychologist in Austin, Texas for 25 years. He is the director of Texans For Safe Education, a citizens group dedicated to challenging the ever-increasing role of psychiatric drugs in schools. He is the author of numerous articles and four books including: The Wildest Colts Make the Best Horses and True Nature and Great Misunderstandings: On How We Care For Our Children According To Our Understanding.

Click here to read The Parental Consent Act

Contact your member of Congress to support The Parental Consent Act. To find your Representative and get their contact information, go to http://www.congress.org/congressorg/directory/congdir.tt to look them up (you need to enter your zip code).

RETURN TO BLOGS PAGE

Blog Feed

CCHR International » Charles Grassley

1 out of every 7 Elderly Nursing Home Residents on Antipsychotics—Despite Risk of Death

Related Posts

Grassley Investigates Drugging of Elderly with Antipsychotics

Related Posts

Top prescribers under Senate’s microscope

U.S. Sen Charles Grassley, R-Iowa, examined Minnesota doctors as part of his investigation into the overprescription of drugs, at great cost to Medicaid and Medicare.

Related Posts

Pfizer Makes Bank from DrugsThat Can Kill You—To say Pfizers been accused of wrongdoing is like saying BP had an oil spill

Related Posts

Senator Grassley Investigates Big Pharma’s Treatment of Drug Company Whistleblowers Who File Complaints

Related Posts

Say what? Psychiatrist Charles Nemeroff who failed to report $1.2 mil in Pharma deals lands psych chairmanship at University

Related Posts

Psychiatrist exposed in Grassley investigation resigns after failing to report hundreds of thousands in Pharma funds

Related Posts

Congressman Ron Paul’s Parental Consent Act

Related Posts