PRESCRIPTIONS: Docs, Undivided, Oppose Tablet-Splitting
In a response to rising drug costs, two Nevada HMOs have ordered their doctors to prescribe higher-dose tablets of Celexa, Lipitor and Zoloft and have instructed patients to split the tablets in half, the Las Vegas Sun reports. Health Plan of Nevada ordered doctors to prescribe the double-dose tablets as of May 1, and then mailed each member a tablet-splitting device. Hometown Health Plan of Reno followed suit for its members who are being prescribed Zoloft. Hometown Health Plan spokesperson John Wheeler said the move trims about 50% from the cost of prescribing two distinct pills of equal dosage at a time when the "cost of prescription drugs are skyrocketing." However, doctors and pharmacists have raised a number of concerns with the cost-cutting technique. "You are leaving it up to the patients themselves to modify their prescriptions," said Dr. Jeffrey Cichon, president of the Clark County Medical Society, adding, "It may be confusing to them." Keith Macdonald, executive secretary of the Nevada State Board of Pharmacy, echoed Chichon's concerns, adding that the tablet- splitting could lead to inaccurate dosages. "All tablets don't break evenly," he said, adding that there "has been no testing done to see if split tablets react the same way" (Nadler, 6/14).
Drug industry representatives teamed with a presidential advisory council yesterday to reassure Americans that they predict uninterrupted access to prescription drugs around Jan. 1. "We can't guarantee that there will be no disruptions at all -- there will always be some glitches in every system -- but we believe this system will be able to respond to anything that will happen," said John Koskinen, chair of the President's Council on Year 2000 Conversion. American Medical Association representatives encouraged people to maintain a seven-day supply of prescription drugs around the year 2000 change, which is the same guideline encouraged under normal circumstances. After the council conferred with industry leaders, it concluded that "drugs follow so many different paths from manufacturer to patient that one or more could be disrupted without major impact," the Nando Times reports (Bowman, 6/15). The real problem, Koskinen said, would be if people hoarded supplies of drugs (Richwine, Reuters/Nando Times, 6/14).