Omnicare, which is the nation’s largest nursing home pharmacy, agreed on Monday to pay more than $28 million to resolve charges of seeking kickbacks from Abbott Laboratories in exchange for boosting prescriptions for a medicine that the drug maker had promoted illegally.
As part of the scheme, Omnicare disguised the kickbacks from Abbott as grants and educational funding, and took rebates from the drug maker based on the amount of Depakote that was prescribed for each nursing home resident. In addition, Abbott paid for Omnicare management meetings at a Florida resort and offered tickets to sporting events, according to the US Department of Justice.
The arrangement between Omnicare and Abbott began after the drug maker launched a new initiative in 1997 to boost prescriptions for the drug, which is approved for treating seizures, bipolar mania, and migraines, but not uncontrollable behavior due to dementia. The following year, Omnicare began soliciting kickbacks from Abbott and the scheme lasted about three years, according to court documents.
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As a hospice nurse I currently see patients in nursing homes who are prescribed Depakote for behavior. It is shameful how our elderly are treated with chemical restraints. There is no easy answer to the problems before us as our population continues to age, but educated caregivers who stand firm against the prevalence of prescribing pills to solve problems must come to an end. I believe in most cases we would all fare better if three or less medications was the the gold standard and GOAL compared to the three pages and average of ten to fifteen medications most of this vulnerable population are taking…including the number one, toxic, over the counter laxative Miralax which is known to cause possible neuropsychiatric events resulting in the need for drugs to treat behavior…no one ever stops to connect the dots.
Very few clean hands:
1) The fact that Omnicare is a criminal enterprise masquerading as a geriatric pharmacy distributor has been known for 20 years.
2) This settlement pales compared to the criminal fine that Lilly had to pay for promoting its “five at five”, which was another nursing home staff reduction program in which Lilly promoted that each patient receive 5 mg of Zyprexa at 5 PM in order to sedate them for the evening. (see link below)
3) Not to excuse the nursing homes themselves, many have entered into a “partnership” program with Medicare to reduce use of neuroleptics such as Risperdal and Seroquel for agitation. For those who don’t know, Medicare rates nursing homes on a five star system, and getting five stars is the holy grail of the nursing home industry. Medicare, in public records has recently stated that the percentage of patients receiving antipsychotics will in the future be one of the major criteria by which the homes are rated, i.e, less neuroleptic use = more stars. Now the homes are forced to use rent-a-shrinks to scour the patient files on a quarterly basis and report back to Medicare on the percentages. So next time you walk into a nursing home and it sounds like a scene out of “Gothika” you’ll know why.
http://www.fda.gov/ICECI/CriminalInvestigations/ucm260967.htm