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Medicare's popular prescription drug program, Part D, covers more than 35 million people and a billion prescriptions annually, but Medicare has never monitored which doctors may be overprescribing medications that are risky for older adults - namely, drugs that are disorienting, addictive or harmful.
The investigative journalism group ProPublica, together with the Washington Post, has now launched a database called Prescriber Checkup, which allows users to search doctors' names and see which ones are frequently prescribing potentially dangerous drugs, such as narcotics and antipsychotics.
ProPublica's report makes public for the first time the prescribing practices and identities of 350,000 doctors and other health care providers. The search of hundreds of millions of records for 2010 revealed that some doctors are using drugs in unapproved ways that may be unsafe or ineffective.
The data, obtained under the Freedom of Information Act, does not reveal patient names.
ProPublica has also provided a list of Medicare's top OxyContin prescribers in 2010, plus a list of risky drugs for older adults.
The Post published a story on ProPublica's findings and a Q and A about the Prescriber Checkup.
Reporters interviewed many of the doctors to ask about their drug-prescription decisions. One was the Miami psychiatrist who has given hundreds of elderly dementia patients the same antipsychotic, despite the government "black box" warning that it increases the risk of death. He told reporters he believes he has no other options.
In addition, reporters found widespread prescribing of drugs such as carisoprodol, a muscle relaxant also known as Soma, which is banned in Europe and is on the American Geriatrics Society's list of drugs seniors should avoid.
In response to the analysis, Medicare officials said the job of monitoring prescribing falls to the private health plans that administer the program, not the government. It's up to the physician to determine if a drug is safe, they said.
It's also, apparently, up to patients to check up on their doctors' drug choices - a task made easier with this database.
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