Bennet, Snowe Call for HHS-Led Taskforce to Reduce Unnecessary, Costly Risks Related to Drug Interactions

New England Journal of Medicine Study: Two-Thirds of Medicare Adverse Drug Reaction Hospitalizations Stem from Four Common Medications

Avoidable Hospital Readmissions of Medicare Beneficiaries Cost Program $17.4 Billion Annually

U.S. Senators Michael Bennet (D-CO) and Olympia Snowe (R-ME) are calling for the Department of Health and Human Services (HHS) to coordinate efforts to reduce unnecessary and costly hospitalizations related to adverse reactions to drugs.

In a letter to HHS Secretary Kathleen Sebelius, Bennet and Snowe request that HHS convene a joint task force with other federal agencies to determine ways to identify patients at risk for adverse drug reactions. The task force would also examine easier-to-understand patient medication guides, care transition that helps with medications, coordination of electronic health records, and e-prescribing to better coordinate care, among other efforts to reduce these unnecessary hospitalizations.

A recent study published in the New England Journal of Medicine (NEJM) found that two-thirds of hospitalizations related to drug reactions stem from four common drug medications – warfarin, insulin, oral anti-platelet agents, and oral hypoglycemic agents – taken either individually or in combination.  

“In light of these facts, it seems clear that action to better educate providers and patients about these common medications with the potential for inappropriate utilization could significantly reduce the number of hospitalizations,” the Senators wrote in the letter. “While you are already undertaking efforts to reduce costs in the health care system, we believe that, in light of this compelling data, the Department can do more to coordinate and ensure the adverse events of these everyday drugs prescribed to our Medicare beneficiaries become the exception, rather than the norm.”

Preventable hospital readmissions due to adverse drug events are among the most significant drivers of health costs. The Centers for Medicare and Medicaid Services estimates that avoidable hospital readmissions of Medicare beneficiaries cost the program $17.4 billion annually, and nearly one-quarter of such readmissions are directly related to adverse drug events.

Full text of the letter is included below.

Dear Secretary Sebelius:

As you continue to find ways to build a strong foundation for quality care in our country by increasing access to care and bending the health care cost curve, we believe that it is imperative to consider further initiatives based on data targeting drivers of health care costs.

Preventable hospital readmissions due to adverse drug events are among the most significant drivers of health costs.  The Centers for Medicare and Medicaid Services estimates that avoidable hospital readmissions of Medicare beneficiaries cost the program $17.4 billion annually.  Nearly one-quarter of such readmissions are directly related to adverse drug events.

On November 24, 2011, the New England Journal of Medicine (NEJM) published an unprecedented study that analyzed data nationwide on hospitalization of Medicare beneficiaries resulting directly from adverse drug reactions.  The study found that two-thirds of these types of hospitalizations stem from four common drug medications – warfarin, insulin, oral anti-platelet agents, and oral hypoglycemic agents – taken either individually or in combination.  

The NEJM study also found that more than 60 percent of adverse drug reaction-related hospitalizations of seniors are linked to accidental overdosing.  All four of the medications identified in the New England Journal of Medicine study have narrow therapeutic indexes, which makes them difficult to take correctly and dramatically increases the likelihood of an accidental overdose.  Evidence shows that many of these hospitalizations are entirely preventable though improved patient education and care management.

In light of these facts, it seems clear that action to better educate providers and patients about these common medications the potential for inappropriate utilization could significantly reduce the number of hospitalizations. While you are already undertaking efforts to reduce costs in the health care system, we believe that, in light of this compelling data, the Department can do more to coordinate and ensure the adverse events of these everyday drugs prescribed to our Medicare beneficiaries become the exception, rather than the norm.

We call for the Department of Health and Human Services to convene a joint task force with other federal agencies such as the Centers for Medicare and Medicaid Services, Centers for Disease Control, Food and Drug Administration, and the Office of the National Coordinator for Health Information Technology to identify rapid improvement mechanisms that would identify patients at risk for these specific adverse drug reactions. Additionally, to prevent these unnecessary and costly hospitalizations, the task force could look more critically at areas such as, but not limited to:

  • Easier-to-understand patient medication guides, including development of a patient checklist;
  • Transitions of care that could help coordinate patient medication;
  • Coordination of electronic health records for Medicare beneficiaries that fall under this high-risk category;
  • E-prescribing as an outreach tool for providers to better coordinate care with patients;
  • Development of preventative measures for patients prescribed to any of these specific medications; and
  • Changes to Medicare reimbursement for hospitalizations due to preventable adverse drugs events.

We look forward to working with you as the Department considers additional ways to drive down health care costs while improving care for our Medicare beneficiaries. Thank you for your consideration.