Former soldiers dealing with the mental scars of war had antipsychotic medications secretly yanked by a Department of Veterans Affairs clinic in West Virginia, which replaced the pills with older, cheaper drugs to cut costs, a government investigation confirmed.
In letters to Congress and the White House on Wednesday, the Office of Special Counsel revealed results of their probe into the Beckley Veterans Affairs Medical Center—a facility that services more than 38,000 veterans in southern West Virginia.
The inquiry substantiated the claims of a whistleblower who alleged that the clinic’s decision to take patients off aripiprazole—a drug often used to treat bipolar disorder and depression—was motivated by economics, not medicine.
“A blanket restriction was imposed…without any appropriate clinical determination regarding changes to patients’ drug regimens,” the agency noted in an analysis based on an investigation by the VA’s Office of the Medical Inspector (OMI).
The investigation uncovered minutes from an April 2013 meeting in which a hospital management committee made the choice to cut back prescribing aripiprazole in order “to meet Pharmacy Cost Saving Goal for FY13 related Atypical Antipsychotics.”
According to Veterans Health Administration regulations, decisions to restrict certain medications “are not to be based solely on economics.”
The cost-cutting practice “may have constituted a substantial and specific danger to public health and safety,” the OMI report noted, adding that mental health providers “voiced concerns to the Committee about the blanket restriction” and cited “concerns about the side effects” of the older medication.
The medical center’s chief of staff claimed to investigators that there were “no automatic changes,” and providers were asked merely to review their patients and consider cheaper alternatives.
Providers, however, “felt they had no option” but to comply, according to interviews with investigators.
The unnamed whistleblower in the matter alleged that the clinic’s pharmacy “mandated that providers first attempt to use older, less expensive medications,” despite the fact that certain recommended drugs can worsen existing conditions. The anonymous tipster also told the OSC that when providers placed order for newer drugs, pharmacy officials “often rejected their orders.”
In its report, the OMI recommended the clinic immediately stop the practice of re-prescribing patients cheaper medications without a legitimate clinical reason, and called on the facility to review all patients whose treatment was affected by the penny-pinching.
A separate recommendation by OMI called for appropriate action to be taken against medical center leadership that violated VA regulations.
