Senators Highlight New Report on Potential Overuse of Anti-Psychotic Drugs on Dementia Patients

WASHINGTON – Today, Sens. Tom Carper (D-Del.), Susan Collins (R-Maine), and Ron Johnson (R-Wis.) highlighted a new Government Accountability Office (GAO) report that found a troubling number of seniors with dementia enrolled in Medicare Part D received potentially improper anti-psychotic medications to treat their symptoms. Most of the medications prescribed have specific warnings not to give to patients with dementia, and their use has not been approved by the Federal Drug Administration (FDA).

The report, Antipsychotic Drug Use: HHS Has Initiatives to Reduce Use among Older Adults in Nursing Homes, but Should Expand Efforts to Other Settings, found that in 2012, of elderly adults with dementia, nearly 30 percent living in nursing homes and nearly 14 percent living outside of nursing home care received these medications, despite FDA warnings. According to GAO, Medicare Part D spent $363 million on these anti-psychotic prescriptions for elderly adults with dementia in 2012.

According to GAO, the Administration has taken significant steps to provide outreach and education in order to reduce antipsychotic prescriptions in the nursing home setting. In fact, some nursing homes have managed to eliminate the use of anti-psychotic medications to seniors with dementia entirely, using behavioral modification techniques and training for nursing home staff. However, GAO recommends that the Administration develop a strategy aimed at reducing antipsychotic drug use among the over 1.2 million seniors with dementia living outside of nursing homes.

“This Government Accountability Office (GAO) report details the troubling reality that many of our nation’s seniors diagnosed with dementia are receiving risky mind-altering medications at too high a cost for their health and taxpayers,” said Sen. Carper, Ranking Member of the Homeland Security and Governmental Affairs Committee. “The rates of improper prescriptions to these vulnerable older adults, and the cost to taxpayers of those prescriptions through Medicare Part D, are deeply concerning. Caring for seniors who suffer from dementia is a difficult job – and a sacred one. We all want to know that our loved ones are receiving the quality of care and attention they deserve from the professionals to whom we entrust their care, and that their health and safety are not being put at risk because of poor oversight.

“Fortunately, GAO outlined a number of steps the Department of Health and Human Services (HHS) has taken starting in 2012 to reduce the instances of improper prescriptions in nursing homes across the country,” Sen. Carper continued. “In Delaware, for example, investments in staff training and other measures to ensure proper care have shown encouraging results, where instances of improper prescriptions in some nursing homes have been significantly reduced or eliminated completely. But despite that progress, there is room to strengthen our efforts to respond to this urgent problem. We must ensure that medical standards are met and best practices are followed by medical professionals and caregivers across the country. And unless Medicare’s policies properly reflect best medical practices, the result will damage not only the program’s financial bottom line but, more importantly, the health and safety of our nation’s seniors. I will work closely with the Government Accountability Office, the Administration, and my colleagues in Congress to see that medical providers and caregivers, including nursing homes, have guidance and resources in place to provide safe and effective treatments to our nation’s elderly.”

“This GAO report raises many red flags concerning the potential misuse and excessive use of antipsychotic drugs for patients with Alzheimer’s and other dementias who are living in nursing homes,” said Sen. Collins, Chairwoman of the Committee on Aging. “Medical experts have long cautioned that antipsychotic medications can be unsafe for dementia patients, and, in fact, many medications include a warning against such patients using these types of drugs.  The GAO found that factors unrelated to the patient—such as low staffing levels—contributed to the over-prescribing of antipsychotic medications.  The GAO’s findings are very troubling.  The Department of Health and Human Services, the nursing home industry, and the medical profession should take immediate action to address this matter.”

“I’m grateful to GAO for bringing this information to light,” said Sen. Johnson, Chairman of the Homeland Security and Governmental Affairs Committee. “Solving a problem starts with understanding its root causes, and that begins with defining the problem. GAO has done that. Dementia is a heart-breaking condition, and its treatment requires particular compassion and expertise. This report contributes to the national conversation about improving best practices for dementia treatment and care for the elderly. I commend GAO for it.”