News in brief - Dec. 25, 2000

Pill splitting, which some health plans are using as a way to reduce costs, is now the subject of a court fight. A trial lawyers' association has filed a class-action lawsuit against Kaiser Permanente over its pill-splitting policy.

Trial Lawyers for Public Justice, a Washington, D.C.-based association representing 2,200 trial lawyers, filed suit Dec. 6 in Alameda County (Calif.) Superior Court.

Plaintiffs in the lawsuit include six patients and a family physician, Charles Phillips, MD. The lawsuit alleges that Dr. Phillips provided emergency department treatment for Kaiser patients whom he believed had hypertension due to inaccurate dosages of blood pressure medication that they had to split themselves.

The suit further alleges that Kaiser Permanente is violating state law and endangering patients' lives by forcing patients to cut higher-dose pills in half so that the insurer can save money on prescription drug costs. Because pharmaceutical companies usually charge the same price for different doses of prescription drug pills, it's cheaper for insurers to pay for a bottle of higher-dose pills that the patient splits in half than for a bottle of lower-dose pills.

In a written statement issued after the lawsuit was filed, Kaiser maintained that its pill-splitting program is voluntary and, furthermore, that the insurer recommends pill splitting only for tablets that are easy to cut.

Pill splitting has become a contentious issue in health care as insurers seek new ways to trim prescription drug costs, which jumped 18.4% last year, according to a recent Center for Studying Health System Change study.

Other insurers also have introduced voluntary or mandatory pill-splitting programs in an effort to cut their prescription drug costs. Health Plan of Nevada established a mandatory pill-splitting policy in April for certain antidepressants and cholesterol-reducing drugs.

After an outcry from doctors and pharmacists, the company modified the policy to require pill splitting only for scored tablets and waived the requirement for patients with disabilities. UnitedHealthcare also unveiled a program last spring that charges patients lower co-payments if they agree to buy higher doses of antidepressants and split them in half.