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States pursue doctors excessively prescribing drugs


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http://www.pharmalot.com/2012/04/more-states-spank-high-prescribing-docs/ US Senator Charles Grassley is a major hero in the battle for the soul of medicine.


Go to the article for links.


More States Spank High-Prescribing Docs

By Ed Silverman April 3rd, 2012 Pharmalot


For the past two years, US Senator Chuck Grassley has pressed all 50 states to provide data on doctors who write huge numbers of prescriptions for specific drugs that are paid for by Medicaid programs. Why? There were reports indicating certain meds - widely used antipsychotics and the OxyContin painkiller - have sometimes been prescribed at unusually high rates.


The underlying concern over prescription drug abuse that leads to unnecessary costs and deaths. “Over prescription of these types of drugs strains the financial viability of the Medicaid and Medicare systems and threatens the health and well-being of the American people,” Grassley said last month at a hearing of the Senate Finance Committee Health Care Subcommittee.


The effort is an outgrowth of an earlier investigation into the financial interplay between physicians and the pharmaceutical industry. At issue has been the extent to which these relationships - which can take place in the form of research grants or fees for speaking and consulting - may unduly influence medical research and practice.


....results have begun to trickle in and there are growing signs that some states are taking action against doctors who have been identified as high prescribers. For instance, Minnesota recently reported two physicians to its Board of Medical Practice for disciplinary action in connection with inappropriate prescribing (read here).


In Oregon, 67 prescribers, or 18 percent of 367 prescribers, were recently terminated from Medicaid contracts after a review of data from three years. State officials say most were due to business changes, but there were 15 specific prescribers who were terminated for loss of license, suspension or other disciplinary actions by the Oregon Medical Board (see this).


Simultaneously, Florida has been terminating contracts for high-prescribing docs to participate in its state Medicaid. The list was up to 10 physicians through January, according to documents provided to Grassley (look here, here, here and here). One also had his license suspended (read here).


And as ProPublica noted last fall, one doctor, Huberto Moreyo, was in demand as a speaker and consultant for several drugmakers (see this and this).


The same approach is also under way in Iowa, where the state Board of Medicine is reviewing top prescribers and the state Department of Human Services identified OxyContin and Xanax as among the drugs for which some physicians have written a large number of prescriptions (read this, this and this).


“While the responses from the states are still being received, many states are still reporting a selection of top ten providers that are prescribing at rates double or triple that of their peers,” Grassley said in a recent statement about the ongoing probe. “While some of these outliers are legitimate providers working in high-volume practices, such as mental hospitals, many cannot be explained away.”


He cited one example in which the top prescriber of antipsychotics in Nevada wrote nearly 6,800 prescriptions for these meds in 2010 and 2011, which was more than 10 times other top prescribers. And this one doc accounted for $2.75 million in payments from Medicaid. By contrast, no one doctor in Colorado wrote more than 2,000 prescriptions for the same drugs over the same period.



This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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  • 3 weeks later...

I was pleasantly surprised to find that Senator Grassley is addressing antidepressant overprescribing also.

Pristiq tapered over 8 months ending Spring 2011 after 18 years of polydrugging that began w/Zoloft for fatigue/general malaise (not mood). CURRENT: 1mg Klonopin qhs (SSRI bruxism), 75mg trazodone qhs, various hormonesLitigation for 11 years for Work-related injury, settled 2004. Involuntary medical retirement in 2001 (age 39). 2012 - brain MRI showing diffuse, chronic cerebrovascular damage/demyelination possibly vasculitis/cerebritis. Dx w/autoimmune polyendocrine failure.<p>2013 - Dx w/CNS Sjogren's Lupus (FANA antibodies first appeared in 1997 but missed by doc).

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As glad as I am to see the attention, way overdue, I'm worried about a hatchet being taken to people on Medicaid. When arbitrary cut off dates are given for the drugs of concern, after which coverage will no longer be available. Then what happens to people who cannot afford the medication themselves, and who are suddenly thrown into catastrophic withdrawal? I don't trust the government to allow people to safely get off.

As always, LISTEN TO YOUR BODY! A proud supporter of the 10% (or slower) rule.


Requip - 3/16 ZERO  Total time on 25 years.


Lyrica: 8/15 ZERO Total time on 7 or 8 yrs.

BENZO FREE 10/13 (started tapering 7/10)  Total time on 25 years.


Read my intro thread here, and check the about me section.  "No matter how cynical you get, it's almost impossible to keep up." Lily Tomlin



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