[Congressional Record Volume 142, Number 62 (Tuesday, May 7, 1996)]
[Extensions of Remarks]
[Page E726]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                      GAO IN SUPPORT OF H.R. 2839

                                 ______


                        HON. FORTNEY PETE STARK

                             of california

                    in the house of representatives

                          Tuesday, May 7, 1996

  Mr. STARK. Mr. Speaker, on December 22, 1995, I introduced a bill, 
H.R. 2839, entitled the Medicare Medication Evaluation and Dispensing 
System of 1995 [MMEDS]. The MMEDS would provide the tools and 
information to beneficiaries that are necessary to reduce the high 
instances of adverse drug interactions, overmedication, incorrect 
duration of drug treatment, and other problems that the elderly face 
with prescription drugs.
  The GAO report issued in July, 1995 called Prescription Drugs and the 
Elderly strongly supports the changes my bill proposes. Statistics show 
that the present system does not serve the elderly well:

       [A GAO analysis] showed that an estimated 17.5% of the 
     almost 30 million senior citizens in the survey used at least 
     one of the drugs generally identified as not suitable for 
     elderly patients in 1992 (p. 4).

  Several studies have shown that adverse drug reactions greatly harm 
the elderly: They cause an estimated 17 percent of the hospitalizations 
of elderly patients, a figure 6 times greater than that of the general 
population, 32,000 hip fractures per year, and 16,000 car accidents per 
year. ``The FDA estimates that hospitalizations due to inappropriate 
prescription drug use cost about $20 billion annually'' (p. 5). Because 
these statistics of harm to senior citizens and the costs associated 
with it are so frighteningly high, the necessity for reform of the 
elderly's prescription drugs dispensing system is further justified.

       According to several experts interviewed [by the GAO], 
     lowering the elderly's risk of adverse drug reactions 
     requires that more detailed information on the impact of drug 
     therapies on the elderly be developed and disseminated to 
     health practitioners . . . Increased communication between 
     and among physicians, pharmacists, and patients is vital to 
     ensuring that this process is effective (p. 8).

  The MMEDS would provide an on-line, real-time prospective review of 
drug therapy before each prescription is filled or delivered to an 
individual receiving benefits under Medicare. The review by a 
pharmacist would include screening for potential drug therapy problems 
due to therapeutic duplication, drug-drug interactions, and incorrect 
drug dosage or duration of drug treatment.

  In the bill I have introduced, as part of the prospective drug use 
review, any participating pharmacy that dispenses a prescription drug 
to a Medicare beneficiary would be required to offer to discuss with 
each individual receiving benefits, or the caregiver of such an 
individual--in person, whenever practicable, or through access to a 
toll-free telephone service--information regarding the appropriate use 
of a drug, potential interactions between the drug and other drugs 
dispensed to the individual, and other matters established by the 
Secretary of DHHS. The Secretary would be given the duty to provide 
written, oral, or face-to-face communication to pharmacists and 
physicians concerning suggested changes in prescribing and dispensing 
practices.
  The report issued by the GAO discusses the need for more oversight of 
the distribution of prescribed medicines to our Nations' elderly. 
Unless something is done, the increase in the number of elderly in our 
society will increase the amount of drugs wrongly prescribed. By 
implementing the Medicare Medication Evaluation and Dispensing System 
Act, we could greatly improve the quality of care our Nation's elderly 
receive when they are prescribed medication.

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