Why does medicare not cover benzodiazepines

When taken together, the effects can be fatal because of the respiratory depression the medications can cause. Olfson, who coauthored a paper on benzodiazepine prescribing practices in , says patterns of benzodiazepine use began to change even before the medication was covered by Medicare Part D. He adds that his research, conducted before the change in Medicare coverage, revealed that benzodiazepine use increases with age, particularly among women.

SchoenbaumMichael Schoenbaum, PhD, senior advisor for mental health services, epidemiology, and economics for the division of services and intervention research at the National Institute of Mental Health, coauthored the report with Olfson and says one in 10 women over aged 65 years received a prescription for a benzodiazepine during the year the research was conducted. Another concerning point, he says, is that most of the people who were prescribed benzodiazepines received prescriptions for pills or more, despite recommendations for short-term use.

Some groups have proposed tracking benzodiazepine use in a manner similar to opioids, with a prescription drug monitoring system. The quick, effective action of benzodiazepines, however, is a double-edged sword. Patients find these medications beneficial, and they also help with certain symptoms and with easing secondary health issues-such as sleep disturbances. Physicians should examine behavioral alternatives or other medications before or instead of prescribing benzodiazepines, but there may be other issues complicating treatment.

Other issues complicating treatment in the elderly in particular may be the use of benzodiazepines in some facilities as a chemical restraint, especially when staffing levels are low. There also is a stigma among elderly patients about seeing a mental health professional, Olfson says. Even when a physician does try to discontinue benzodiazepines, there is usually a lot of resistance from patients.

Some health plans require attestation that medications such as benzodiazepines are still needed after a certain period of time, but not all, Olfson says. Payers could help police use by programming audits to investigate the clinical justifications for benzodiazepine prescriptions, Olfson says. Use should not be completely restricted in seniors, or in any population, but a bit more oversight may be helpful, he adds. Ong agrees that benzodiazepines should not be broadly limited-in spite of the risks.

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