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Thursday, April 26, 2018

With Lori Swanson being a principled and active AG, it would cheer me if she were to investigate Nuedexta use among Minnesota nursing home residents.

Given CNN reporting, it would seem to be a fine litmus test of institutions possibly in need of further scrutiny. If such a review were to prove lack of any problem, negative information is useful nonetheless, and the scope of public attention needed to at least begin a litmus test of such a kind would not be a budget breaker.

Not being in medical practice of any kind, nor having training, this is an opinion from the public about a possible cost-benefit balance where cost would not be prohibitive. Opiate over-prescription is a far bigger situation. Hence, it would not be as easily contained a study by law enforcement's looking at practices. Neudexta might offer a focal point to study one arguably problematic over-prescription problem with a favorable cost-benefit balance, because of scale and single drug involvement. This is presuming CNN would not publish without having cause, and with prior review of counsel to not be wrongly criticizing a multi-million dollar Big Pharma player.

At my age of 73 while actively in the public with no glaring health issues, nursing home practices are nonetheless a close concern. Age is the culprit making nursing home residency a necessary evil for some, and for those in such a care facility, may they only benefit and not be in peril of bad practices. Elderly care residents are clearly a fragile subpopulation where risks should be minimized.

The CNN item stated in part:

Since 2012, more than half of all Nuedexta pills have gone to long-term care facilities. The number of pills rose to roughly 14 million in 2016, a jump of nearly 400% in just four years, according to data obtained from QuintilesIMS, which tracks pharmaceutical sales. Total sales of Nuedexta reached almost $300 million that year.

Nuedexta is being increasingly prescribed in nursing homes even though drugmaker Avanir Pharmaceuticals acknowledges in prescribing information that the drug has not been extensively studied in elderly patients -- prompting critics to liken its use to an uncontrolled experiment. The one study the company conducted solely on patients with Alzheimer's (a type of dementia) had 194 subjects and found that those on Nuedexta experienced falls at more than twice the rate as those on a placebo.

Avanir declined repeated requests to be interviewed for this article. [...]

The federal government foots the bill for a big portion of the money being spent on Nuedexta in the form of Medicare Part D prescription drug funding, for people 65 and over and the disabled. In 2015, the most recent year for which data is available, this Medicare program spent $138 million on Nuedexta -- up more than 400% from just three years earlier.

This seems far from any "atta-boy" endorsement of a situation.