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Tag Archives: doctor shopping
A new study by the Department of Health and Human Services highlights a variety of problems concerning prescription medication practices among doctors and pharmacies servicing Medicare patients, including over-prescribing, over-billing, and over-medicating.
The review identified 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, according to this article.
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 article says.
All told, the drugs ordered by the doctors labeled “extreme outliers” cost Medicare $352 million, according to the study.
In 2008, more than 36,000 people died from drug overdoses, and most of these deaths were caused by prescription drugs, according to the CDC.
Nearly three out of four prescription drug overdoses are caused by prescription painkillers. The unprecedented rise in overdose deaths in the U.S. parallels a 300% increase since 1999 in the sale of these medications, which were involved in 14,800 overdose deaths in 2008, more than cocaine and heroin combined, the CDC says.
Although federal regulators have long had their eye on the online market for prescription pills, it is still disturbingly easy to find a rogue Internet pharmacy that will sell painkillers like codeine and hydrocodone without a prescription, according to this article. Research shows that 97% of Internet pharmacies are not operating legitimately and most of those do not require a prescription at all, the article says. Many of these pharmacies are based overseas, and will provide the medication even if customers are underage, the article says.
According to the article:
With an estimated 40,000 to 50,000 rogue Internet pharmacies in operation, law enforcement agencies face an uphill battle shutting down online pharmacies dispensing drugs without a prescription, especially when their operations cross many international jurisdictions.
Buying prescription medicine from fraudulent online pharmacies can be dangerous, or even deadly, according to the FDA. Such pharmacies are likely to be selling counterfeit medicines, which may be less effective or have unexpected side effects; in addition, online pharmacies may intentionally misuse the personal and financial information provided by customers, and sell this information to other illegal websites and Internet scams, the agency says.
As the prescription drug epidemic in New York’s Staten Island gets more attention, addicts and criminals are discovering it increasingly difficult to get doctors here to write new prescriptions for oxycodone, or find pharmacies willing to fill those scripts for new patients, which is pushing people elsewhere to obtain the painkiller, according to this article. An analysis of state health department data showed that in 2012, borough residents received 141,481 prescriptions for the drug; Staten Island physicians were responsible for writing out 110,327 of those prescriptions, meaning at least 31,000 of Islander’s scripts, possibly more, come from off-Island doctors, the article says.
Similarly, pharmacies in the borough filled out 122,048 oxycodone prescriptions in 2012, indicating that residents went off-Island to fill at least 19,400 of their scripts, the article says.
By comparison, Manhattan residents received just 264,271 prescriptions for oxycodone last year, but doctors there wrote out nearly twice as many scripts there — 514,819 in total, according to the article.
And unfortunately, the dwindling supply of pills may start to push people towards other dangerous opiates, according to one treatment director quoted in the article:
Everybody who’s been using for the past 10 years, they aren’t going to stop. They’re going to heroin.
The California Senate has given the stamp of approval to a package of bills aimed at reducing prescription drug abuse and overdose deaths, including a measure that would require coroners to report deaths involving prescription drugs to the Medical Board of California. The Los Angeles Times reports that the Senate also signed off on a bill that would upgrade the state’s prescription drug monitoring program, known as CURES. In addition, lawmakers approved a measure that would make it easier for the medical board to investigate physicians suspected of overprescribing and suspend their prescribing privileges, and a bill that would prohibit pharmacies from advertising commonly abused narcotic medications, such as OxyContin and Vicodin, according to the LA Times.
The package of legislation will now move on to the California Assembly for approval.
The CURES bill faced the strongest opposition from the pharmaceutical and biotech industries, the Times says, even though it had the support of a coalition of law enforcement groups, health insurance companies, and business, labor and consumer organizations. That opposition was dropped after the bill’s sponsors removed a provision that called for a tax on drug makers to pay for teams of investigators to crack down on drug-seeking patients and doctors who recklessly prescribe to them, according to the Times.
The Minnesota Medical Association is considering requiring doctors to take continuing education courses on pain management and addiction and increasing use of the Minnesota Prescription Monitoring Program in order to deal with the state’s prescription drug abuse issue, according to this article. As of March 2013, only 40% of pharmacists and 30% of doctors in Minnesota were using the monitoring system, according to the article.
Georgia’s new prescription drug monitoring database, which is set to become operational in June, may run out of the money it needs to operate soon after its implementation because lawmakers failed to appropriate any funding for the program when they passed legislation to create it in 2011, according to the Atlanta Journal-Constitution.
A two-year, $400,000 federal grant that pays startup costs for a new prescription monitoring program grant expires Sept. 30, the paper says.
In Georgia — which is among the last six states in the nation to put a prescription monitoring program in place, according to the National Alliance for Model State Drug Laws — prescription drug abuse causes or contributes to the overdose deaths of 11 people every week.
A Southern California doctor will plead guilty to charges of illegally prescribing powerful prescription painkillers to patients at nightly meetings in Starbucks coffee shops, ABC News reports.
The patients paid up to $600 to see Dr. Alvin Mingczech Yee at Starbucks locations across suburban Orange County in exchange for drugs such as OxyContin and Vicodin, according to ABC.
His plea agreement recommends a prison sentence between eight and 10 years, ABC says.
One of Yee’s patients, a 21-year-old woman, died of a drug overdose in 2011 after he prescribed drugs for her, and Yee may be associated with several other overdose deaths as well, according to the Los Angeles Times.
The LA Times recently issued a report finding that the California Medical Board has repeatedly failed to protect patients from reckless prescribing by doctors: it rarely tries to suspend the prescribing privileges of doctors under investigation, and even when it imposes sanctions, in most cases it allows doctors to continue practicing and prescribing. The Times’ examination of board records and county coroners’ files from 2005 through 2011 found that eight doctors disciplined for excessive prescribing later had patients die of overdoses or related causes; prescriptions those doctors wrote caused or contributed to 19 deaths.
Iowa has taken an interesting approach towards stopping the practice of seeking out multiple doctors for painkiller prescriptions with a program that “locks” Medicaid recipients into using one doctor, one pharmacy and one hospital. And according to this article, the program appears to be having some positive results: by locking in more patients, the state saved $14.8 million from July 2010 through September 2012 in the cost of drugs and doctors’ visits.
The number of “locked-in” Iowa Medicaid recipients has increased sevenfold from 200 in 2010 to 1,430 in January, the article says, a jump that came after Iowa Medicaid started screening patients not for just doctor-filled prescriptions, but for non-emergency visits to hospital emergency rooms.
The state’s prescription drug monitoring program was launched in March 2009, but only one-quarter of Iowa doctors and prescribers are registered to use the database, which includes more than 4.2 million prescriptions annually, the article says.
Prescription painkillers caused 62 deaths in Iowa in 2011, up from just four deaths in 2000, while prescription abuse treatment admissions more than quadrupled from 187 in 1999 to 878 in 2009, according to the Iowa Department of Public Health.
Like many states, North Carolina has implemented a prescription drug monitoring database to identify people who abuse and misuse powerful painkillers. Now, a new study at the University of North Carolina at Chapel Hill shows that the system – which is voluntary – is only used by about one-third of the 34,000 physicians who are registered with the Drug Enforcement Agency to prescribe controlled substances – and fewer than half of those registered actually used it in the last six months of 2011.
However, at the same time, the number of patients with the most severe drug-seeking behaviors – those who used 10 prescribers and 10 pharmacists within six months – decreased substantially from 217 in 2008 to 115 in 2012, the study found.
Prescription drug overdose kills an average of three people per day in North Carolina.
Nearly all states have operational prescription drug monitoring programs, with the exception of Montana, Nebraska, Arkansas, Wisconsin, Georgia, Maryland, New Hampshire, and the District of Columbia, according to the latest research from the Alliance of States with Prescription Monitoring Programs.
Parents whose children died of drug overdoses urged California’s medical board on Monday to utilize a tracking database of prescriptions to help identify doctors who over-prescribe powerful narcotics amid the state’s growing addiction epidemic. The testimony came from members of advocacy organizations, including the National Coalition Against Prescription Drug Abuse, and other individuals and experts who said the board’s failure to investigate complaints of physician misconduct in a timely manner has often had deadly results.
By the time parents were allowed to start their testimony, several of the board’s members had wandered out of the hearing, leaving only five active listeners (the board currently has 15 members.) When one of the parent speakers – a registered nurse whose son was addicted to pills and died of a heroin overdose last year – asked when the full board would be available, one of the members replied “soon” and added that everyone’s testimony would be transcribed.
Not very reassuring.
Among the powerful speakers were Bradley DeHaven, whose son was previously addicted to OxyContin; April Rovero, the founder of NCAPDA after her son died of a prescription drug overdose; and Jodi Barber, producer of the short film Overtaken who lost her son to an Opana overdose.