Government auditors say overuse of antipsychotics is putting elderly patients at risk. Nearly one in seven nursing home residents get atypical antipsychotics, even though they're not approved for dementia treatment. In fact, the drugs carry an FDA warning that use can increase the risk of death in the elderly. This means that more than half of the antipsychotic prescriptions Medicare paid for during the first half of 2007 were "erroneous," the Health and Human Services Inspector General has found. And that cost the federally funded program $116 million.
The Center for Medicare and Medicaid Services has blamed some of the overuse on drugmakers promoting their atypical antipsychotics for off-label use, sometimes paying kickbacks to doctors. As the NYT notes, the nursing home pharmacy services firm Omnicare in 2009 paid $98 million to settle allegations that it took kickbacks from Johnson & Johnson and other drugmakers for boosting antipsychotic prescriptions.
Drug companies have paid hundreds of millions--even more than $1 billion--to settle off-label marketing probes involving their antipsychotic drugs. Eli Lilly, for instance, agreed to pay $1.4 billion to wrap up an investigation of its Zyprexa marketing practices. Bristol-Myers Squibb agreed to a $515 million settlement in a probe of its Abilify marketing. AstraZeneca paid $520 million to settle claims that it marketed Seroquel for off-label use. And Pfizer's $2.3 billion marketing settlement covered several drugs, including its antipsychotic Geodon.
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