Aug 27, 2020 • 29M

Dr. Rachel Dolin Discusses the House Ways & Means Committee's Recent Report,"Under-Enforced and Over-Prescribed: The Antipsychotic Drug Epidemic Ravaging America’s Nursing Homes” (August 27th)

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David Introcaso, Ph.D.
Podcast interviews with health policy experts on timely subjects. The Healthcare Policy Podcast website features audio interviews with healthcare policy experts on timely topics. An online public forum routinely presenting expert healthcare policy analysis and comment is lacking. While other healthcare policy website programming exists, these typically present vested interest viewpoints or do not combine informed policy analysis with political insight or acumen. Since healthcare policy issues are typically complex, clear, reasoned, dispassionate discussion is required. These podcasts will attempt to fill this void. Among other topics this podcast will address: •Implementation of the Affordable Care Act •Other federal Medicare and state Medicaid health care issues •Federal health care regulatory oversight, moreover CMS and the FDA •Healthcare research •Private sector healthcare delivery reforms including access, reimbursement and quality issues •Public health issues including the social determinates of health Listeners are welcomed to share their program comments and suggest programming ideas. Comments made by the interviewees are strictly their own and do not represent those of their affiliated organization/s.
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In testimony before the House Energy and Commerce Committee in 2007, the FDA's Dr. David Graham stated, "15,000 elderly people in nursing homes [are] dying each year from the off-label use of antipsychotic medications for an indication that the FDA knows the drug doesn't work.  The problem has been known to the FDA for years and years.”  Eleven years later, Human Rights Watch published a report titled, “They Want Docile: How Nursing Homes in the US Over-Medicate People with Dementia."  The report found in 2016-2017 "massive use" or abuse of anti-psychotics, e.g., Seroquel, Haldol and Risperdal, that have serious side effects including sudden cardiac death.  In testimony before the Ways and Means Committee last November Nov., Richard Mollot, Executive Director of the Long Term Care Community Coalition, concluded, “the use of antipsychotics in nursing facilities is “so extensive that it puts the US in violation of . . . international conventions and covenants on torture and cruel, inhuman and degrading treatment or punishment.”  Dedicated listeners may recall I interviewed Diana Zuckerman on this topic in December 2012 and in February 2018 interviewed Hannah Flamm author of the Human Rights Watch Report. 

During this 30 minute interview, Dr. Dolin discusses report specifics including its findings regarding the extent of overuse and misuse, what explains overuse, the success of CMS' voluntary program to reduce misuse and the consequences of Trump administration's decision to place a moratorium on skilled nursing facility regulatory enforcement and decisions to reduce civil monetary penalties.  Dr. Dolin also explains why majority staff did not offer recommendations in the report and opines on whether the report will lead the Congress to, finally, address the misuse of anti-psychotics in nursing homes.   

Rachel Dolin, Ph.D., is Democratic Professional Staff with the Committee on Ways and Means, Subcommittee on Health.  She is the principle author of "Under-Enforced and Over-Prescribed."   Previously, Dr. Dolin was a 2017 David A. Winston Health Policy Fellow.  Previously still, she was a National Science Foundation Graduate Research Fellow from 2013-2017.  Prior to her doctoral work she was employed as researcher for L&M Policy Research in Washington, D.C.  Her work has been featured on NPR, in Health Affairs and in other peer-reviewed journals.  Dr. Dolin received her B.A., magna cum laude, in Political Science and History from Tufts University and completed her PhD in Health Policy and Management at the Gillings School of Global Public Health at the University of North Carolina at Chapel Hill. 

The Ways and Means "Under-Enforced and Over-Prescribed" report is at:

Richard Mollot's November 2019 testimony before the Ways and Means Committee is at:

Dr. David Graham's 2007 testimony is at: