Neal Seeks Collaboration with Pharmacies to Combat the Overuse of Antipsychotics in Nursing Homes

Aug 29, 2019
Press Release

WASHINGTON, DC – Today, Ways and Means Committee Chairman Richard E. Neal (D-MA) sent letters to Alan Rosenbloom, President and CEO of the Senior Care Pharmacy Coalition, and Bill Osborn, President National Community Pharmacists Association, regarding the persistent overuse of antipsychotics in nursing homes as a chemical restraint. Currently, more than 20 percent of all nursing home residents continue to receive antipsychotics, while only about two percent have qualifying conditions that would medically indicate such drugs are appropriate. Chairman Neal asserted that long-term care (LTC) pharmacies could play a vital role in the monitoring and oversight of this problem. 

In his letters, Chairman Neal pointed out that “nursing homes have made only limited progress toward the Centers for Medicare & Medicaid Services’ (CMS) goal of curbing the practice of inappropriately prescribing antipsychotics to nursing home residents.” Neal noted that he is “concerned that CMS’s cited progress in reducing inappropriate prescribing may not reflect a true reduction in antipsychotic use but, instead, may stem from falsified psychosis diagnoses.”

Patients over 70 are 3.5 times more likely than younger individuals to be hospitalized due to antipsychotic-related adverse drug reactions, with negative implications for Medicare spending. The Food and Drug Administration even issued a black box warning for the use of antipsychotic drugs, indicating that when elderly patients with dementia are treated with them, they face a two-fold risk of death, as well as other adverse events, such as hip fractures, thrombotic events, cardiovascular events, and hospitalizations. 

“Given the role of LTC pharmacies in monitoring and guiding nursing facilities in best practices for medication administration, I am examining specific activities, strategies, and monitoring of antipsychotics that LTC pharmacies could engage in to help rectify this problem,” Chairman Neal wrote. He requested the two pharmacy organizations provide detailed information regarding their practices and recommendations to monitor and reduce the inappropriate use of antipsychotics in nursing homes. 

“I know we all share the goal of improving patient care for residents in nursing home facilities, and I look forward to working with your member pharmacies to address this crisis,” added Neal.
Full text of the letter to Mr. Rosenbloom is available HERE, and the letter to Mr. Osborn can be found HERE