Resources for Physicians

Are Statins Overprescribed to the Elderly?

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Seniors with no history of heart trouble are now nearly four times more likely – from 9 percent to 34 percent – to get statin drugs than they were in 1999.

Seniors with no history of heart trouble are now nearly four times more likely – from 9 percent to 34 percent – to get statin drugs than they were in 1999.

Inexpensive statin drugs are given to millions of people to reduce cholesterol, even many who do not show signs of heart disease. But a recent study has found that seniors with no history of heart trouble are now nearly four times more likely – from 9 percent to 34 percent – to get those drugs than they were in 1999, according to Kaiser Health News.

Here’s the catch: For patients of that age, there is little research showing statins’ preventive heart benefits outweigh possible risks, which can include muscle pain and the onset of diabetes.  There have only been a handful of studies that included the over-79 population, according to a review in the American Journal of Cardiology in 2012, Kaiser reports.

The rate of statin use among octogenarians and beyond who don’t  have a history of heart attack, stroke, coronary heart disease or vascular heart disease increased four times from 1999 through 2012, according to two researchers from Ohio State University and the University of Alberta in Edmonton, Canada.  Their research letter was published in the Journal of the American Medical Association Internal Medicine in August.

Despite the lack of evidence to guide the use of statins in this population, “the very elderly have the highest rate of statin use in the United States,” they said, citing past studies.

Concerns about statins’ effects in those older than 79 are being raised as some cardiologists question whether statins are overprescribed even among some younger people.

Read entire article here.


Older Adults Not Getting Recommended Vaccines

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Skipping necessary vaccines leaves millions of older adults at risk of dying, being hospitalized, or suffering debilitating effects that last for years.

Skipping necessary vaccines leaves millions of older adults at risk of dying, being hospitalized, or suffering debilitating effects that last for years.

Three out of four Americans older than 60 don’t get a shingles vaccine to protect themselves from the virus’ miseries: rashes over the face and body, stinging pain that can last for weeks or months and the threat of blindness, reports Kaiser Health News.

Many older adults are not getting their recommended vaccines. The rates for older adults getting flu, pneumonia, tetanus or shingles shots – the four most used vaccines among the elderly – have stayed flat and trail national goals, according to latest federal data. That leaves millions of older adults at risk of dying, being hospitalized, or suffering debilitating effects that last for years.

— One in three seniors each year skips the flu vaccine, recommended annually for everyone over 6-months-old. Between 3,000 and 49,000 Americans, primarily older adults, died of flu or related illnesses each flu season for 30 years through 2007, according to the Centers for Disease Control and Prevention’s latest estimates. Immunization rates for seniors have been around 65 percent for more than 15 years. The federal government’s goal is 90 percent by 2020.

— Four in 10 seniors are not vaccinated for pneumonia. It’s recommended once for people 65 and older who did not have it previously. Pneumonia affects about 900,000 seniors a year. Immunization rates are up only slightly in the past decade.

— Nearly half of seniors are not immunized for tetanus. A shot is recommended once every 10 years to prevent a rare but often deadly bacterial condition known as “lockjaw.” Vaccination rates have changed little since 2008.

— The shingles vaccine has the lowest adoption rates by older adults regarding those leading preventives — 76 percent of them had not received it as of 2013, the latest year that data is available. There are an estimated 1 million cases each year in the United States, half among people older than 60. Shingles is caused by a reactivation in the body of the same virus that causes chickenpox. The vaccine, approved in 2006, is recommended once for everyone age 60 and over, regardless whether they had chickenpox. Nearly one out of three people in the United States will develop shingles in their lifetime.

Read entire story here from Kaiser Health News.


Medicare Itemizes Its $103 Billion Drug Bill

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The most frequently prescribed drug was lisinopril, a generic used to treat high blood pressure and help patients survive after heart attacks. The drug was prescribed or refilled nearly 37 million times by more than 7 million Medicare beneficiaries at a cost of $307 million.

The most frequently prescribed drug was lisinopril, a generic used to treat high blood pressure and help patients survive after heart attacks. The drug was prescribed or refilled nearly 37 million times by more than 7 million Medicare beneficiaries at a cost of $307 million.

By Jordan Rau, Kaiser Health News

The federal government popped the cap off drug spending on Thursday, detailing doctor-by-doctor and drug-by-drug how Medicare and its beneficiaries spent $103 billion on pharmaceuticals in 2013.

The data show that 14 drugs cost the federal government and Medicare beneficiaries more than $1 billion each, accounting for nearly a quarter of Medicare prescription drug spending in 2013. Most of those drugs are used to treat chronic conditions that plague the elderly, including diabetes, depression, high cholesterol and blood pressure, dementia and asthma.

The brand drug Nexium, used to treat heartburn, acid reflux and related stomach ailments, cost the most: $2.5 billion for 1.5 million Medicare patients, who filled 8 million prescriptions and refills. The total cost included what was paid by Medicare, beneficiaries and third party groups such as supplemental health plans. The cost covered not just the drug ingredients but also sales tax and dispensing fees. It did not, however, include sometimes substantial manufacturer rebates, and the drug makers’ trade group warned that omission distorted the actual cost.

The most frequently prescribed drug was lisinopril, a generic used to treat high blood pressure and help patients survive after heart attacks. The drug was prescribed or refilled nearly 37 million times by more than 7 million Medicare beneficiaries at a cost of $307 million. Read more