Perspective: Medicare Pharmacy Coverage: Ensuring Safety Before Funding

Suboptimal Prescribing in Elderly Outpatients: Potentially Harmful Drug‐Drug and Drug‐Disease Combinations

“…[1][2][3] Using published expert consensus, [4][5][6] researchers have examined the prevalence of, risk factors for, and adverse effects of potentially inappropriate medications in community-dwelling elderly, 3,7 physician offices, 8 and nursing homes, 9 but previous studies have primarily assessed the use of individual medications that are considered to be inappropriate for the elderly regardless of diagnosis or concurrent use of other drugs. DESIGN: Retrospective analysis of the 1995-2000 National Ambulatory Medical Care Survey (NAMCS) and the National Hospital Ambulatory Medical Care Survey (NHAMCS).…”

Sound‐alike and Look‐alike Drugs An Overdue Opportunity to Reduce Medical Errors

“…For example, cardiac defibrillators are described by the ANSI/AAMI DF2: 1996-Cardiac defibrillator devices standard; however, this standard provides for only minimum labeling, performance, and safety requirements for cardiac defibrillator devices, and includes referee test methods by which compliance can be verified. 2 The standard does not provide for standardization of knobs, displays, and other operator interface components in the way that the standard for anesthesia delivery machines does.…”

“…4 With pharmacies filling 2.9 billion outpatient prescriptions last year, one can see that even small error rates have large potential consequences (as an error rate of 1% endangers several million patients). 2 To reinforce the magnitude of the problem in the United States, current per-capita drug spending is more than $300 per year, an all-time high. 5 Interestingly, the European counterpart of the Food and Drug Administration (FDA), the European Agency for the Evaluation of Medicinal Products, has worked to minimize similar mistakes in prescribing the wrong drug by insisting that new drug names coming to market differ from existing names by at least three letters.…”

“…In reality, the magnitude of the problem is not insignificant in that prescribing errors have been reported to kill more people than automobile collisions, work injuries, and airline crashes. 2 Interestingly, although Americans have only 0.43 fatalities per million miles traveled in an airplane, they accept 1,250 fatalities per million patients from drugrelated errors. 3 When a clinician decides to prescribe a medication, multiple issues must be simultaneously considered.…”

Health Care Errors: A Perspective on the Problem

“…Newcomer (2000) states that it is time for federal government intervention. Fatality rates have improved in the areas of automobile safety, occupational safety, and airline safety following government intervention.…”