Kaiser Permanente Sued for ‘Pill-Splitting’ Practice
The Trial Lawyers for Public Justice, a public interest law firm representing six patients enrolled in Kaiser Permanente, have filed suit against the not-for-profit HMO, charging that it forced patients to split pills as part of a "cost-saving" effort, NPR's "All Things Considered" reports. According to Arthur Bryant, a TLPJ lawyer, Kaiser Permanente has violated California better business laws and "is simply trying to save money at the expense of patient health." He said, "Kaiser's mandatory pill-splitting policy offers no therapeutic benefits to patients whatsoever. The sole reason for the policy is to put more money in Kaiser's coffers, even while risking the patient's health." Dr. Charles Phillips, a private practice physician who used to work for Kaiser Permanente, expressed "adamant" concerns about pill-splitting, calling the practice "dangerous." Pointing to recent studies, Phillips warned that even healthy, non-elderly patients cannot "split pills evenly," often administering doses that vary as much as 40%.
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While Kaiser Permanente officials deny that such a pill-splitting policy exists, they admit that the HMO encourages patients to divide certain medications in some cases, blaming double-digit inflation in the cost of prescription drugs. "When a tablet is available in multiple doses and the price for each of those dosaging strengths is the same, if you can make a higher dose in a half tablet available, you're essentially saving the patient money, and you're saving the organization money," Dr. Sharon Levine, director of Kaiser Permanente's pharmacy services, said. Levine also insisted that the HMO does not force patients to split pills, calling the program "entirely ... voluntary." Noting that Kaiser Permanente only recommends splitting about 10 out of 1,000 medications, she added that the HMO uses "rigid criteria" -- such as how patients absorb the drug and whether patients can divide pills "consistently" into equal doses -- to determine when to split pills. Levine also said that the HMO considers whether doctors and patients agree to split medications, a claim denied by patients in the lawsuit. One patient reported, for example, that she received a razor blade centered in a "small, plastic instrument" with her "bigger than usual" blood pressure prescription to split the pills. When she attempted to divide the pills, however, they either "crumbled into powder" or "flip[ped] across the room." While Kaiser Permanente officials refused to comment on the lawsuit, they pledged to investigate any cases of patients forced to split pills (Neighmond, NPR's "All Things Considered, 12/5). To listen to the NPR report, go to http://www.npr.org/ramfiles/atc/20001205.atc.04.ram. Note: You must have RealPlayer G2 to listen to the report.