In 2006, Medicare changed their coverage plan to exclude anti-anxiety medications (namely benzodiazepines), limiting access to these medications for many elderly and disabled individuals covered under Medicare. Then in 2013, the federal health program once again modified their coverage plan, adding anti-anxiety medications back to their coverage system.

Now, after this re-implementation, Medicare has filled almost 40 million prescriptions for benzodiazepine anti-anxiety medications in just one year, costing them over $377 million. These numbers indicate a stunningly high rate of use for these medications, and a huge volume of money provided by the government for anti-anxiety drugs. Morever, it was found that initially excluding benzodiazepines from Medicare didn't seem to discourage use - a majority of the prescriptions filled by Medicare in 2014 were refills for already existing prescriptions, not new ones, meaning that patients continued using benzodiazepines even while they weren't covered by Medicare. Doctors didn't stop prescribing these drugs, so patients were instead paying for medication out of pocket.

Benzodiazepines Aren't Always the Best Option for Treating Anxiety

So, why is this new finding concerning? It seems like these results should be a positive - those suffering from anxiety and covered under Medicare now have easier access to medication. However, many are concerned by this news, which indicates a huge rate of use for benzodiazepines. While benzodiazepines, which include Xanax (Alprazolam), Ativan (Lorazepam), Valim (Diazepa), and Klonopin (Clonazepam), are in the top 50 most prescribed drugs in the Medicare system, multiple studies are now examining and uncovering the possible downsides of the medication.

Benzodiazepines are traditionally used to treat anxiety, insomnia, and seizures, and are valued by doctors and panic attack sufferers because of their very quick-acting effects. However, benzodiazepines also have a tendency to be abused, and can become addictive. The tendency of patients to build a tolerance to benzodiazepines means that they should only be used as a short-term solution, rather than as a drug to rely on. However, many patients have use the medication for years.

Benzodiazepines can Present Serious Risks for the Elderly

Lastly, this news is also disturbing because of the demographics represented by those enrolled in Medicare coverage: the elderly. The American Geriatrics Society strongly urges against the use of benzodiazepines by seniors, citing possible cognitive impairment and delirium. In the geriatric population, the medication has been linked to high levels of abuse, increased risk of Alzheimer's disease, and an increased incidence of falls and fractures. Critics of the high numbers of benzodiazepine prescriptions are worried that doctors are recklessly prescribing the medication as a sedative, without considering the list of risks and downsides. This, unfortunately, creates more problems than it does solutions, and the 40 million prescriptions filled by Medicare in 2013 could be a strong indicator that doctors have to change the way they approach geriatric anxiety.

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Michael Wheaton, Ph.D.


Date of original publication:

Updated: June 12, 2017