Prescription drugs: Over prescribed, over billed and over medicated

Costly and widespread use of prescription medication in the U.S. raise concern in new study by Department of Health and Human Services. Photo: wikicommons

WASHINGTON, June 24, 2013 — A study released in June 2013 by the Department of Health and Human Services reveals alarming, although not surprising, problems of prescription medication practices among doctors and pharmacies servicing Medicare patients. According to the study, the problems include over-prescribing, over-billing, and over-medicating. Medicare part D, Medicaid, and ultimately the tax-payer pays for these problems.

There were a total of 1.1 million prescribers who ordered Part D drugs for Medicare beneficiaries in 2009. These prescribers included many specialties, such as general-care physicians, dentists, and nurse practitioners. These individuals ordered over one billion prescriptions during the year. In total, Medicare paid $70.7 billion for these prescriptions. On average, these 1.1 million prescribers each ordered Part D prescriptions costing $64,102. On average, each prescriber ordered prescriptions for 80 beneficiaries and averaged six prescriptions per beneficiary.

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“The review found more than 2,200 doctors whose records stood out in one of five areas: prescriptions per patient, brand name drugs, painkillers and other addictive drugs or the number of pharmacies that dispensed their orders,” wrote ProPublica reporters in a press release.

More than half of 736 physicians studied wrote prescriptions for extremely high amounts of controlled substances that have the potential for addiction and abuse. The most commonly prescribed drugs, the report found, include antibiotics, antidepressants and opioid painkillers.The most commonly abused painkillers are oxycodone, morphine, and hydrocodone,  Overdoses of these prescription painkillers—called opioids—are among the leading causes of accidental death in the United States.These are dangerous medications, prescriptions written mostly for the elderly and disabled. 

Jennifer St. Sauver, Ph.D., the study author said, “Often when people talk about health conditions they’re talking about chronic conditions such as heart disease or diabetes. However, the second most common prescription was for antidepressants — that suggests mental health is a huge issue and is something we should focus on. And the third most common drugs were opioids, which is a bit concerning considering their addicting nature.”

The finding also showed women and the elderly receive more prescriptions overall than other patients

The Centers for Medicare & Medicaid Services (CMS) contracts with private insurance companies and provides drug coverage to beneficiaries who choose to enroll. In 2011, 36 million beneficiaries were enrolled. The Centers for Disease Control and Prevention (CDC) has characterized prescription drug abuse as an epidemic.

The study showed one doctor in California with what CMS calls ‘extreme outliers’ with regard to prescriptions cost Medicare $9.7 million. According to the study, extreme outliers are physicians whose patters raise questions about whether their prescriptions are “legitimate or necessary.”

The total cost of prescriptions written by ‘extreme outliers’ totaled $352 million, according to the report.

While the study specifically highlighted Medicare patients, it is likely this same pattern of abuse replicates in other patients.

Until the Center for Medicare Services provides more oversight to prescription drugs, you could be at risk.

Patients should educate themselves on their medications, and can take advantage of pharmacist counseling to gleain information. They can also ask pharmacist for black box warnings or contraindications to their medications. Pharmacists often offer drug reviews and many times will communicate with physicians when there are concerns about certain drugs. 

Dr Peter Lind practices metabolic and neurologic chiropractic in his wellness clinic in Salem, Oregon. USA. He is the author of three books on health, one novel, and hundreds of wellness articles. His clinical specialty is in physical, nutritional, and emotional stress. 

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Peter Lind

Dr. Peter Lind has written five books about healthy lifestyle and specifically subjects such as food, diet, nutrition, exercise, and stress. He has written one thriller about agriculture genetic engineering that has been written into a screenplay. 

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