State board finds rules on splitting a bitter pill

Wednesday, Dec. 15, 1999 | 10:15 a.m.

CARSON CITY -- The state Pharmacy Board has backed away from writing regulations that would cover the practice of pill splitting.

The practice is controversial because it requires patients to split their own pills, risking the chance that they may get the wrong dosage and also saddling patients with the oftentimes difficult task of splitting pills that have not been grooved.

Keith Macdonald, executive director of the board, told a legislative committee on health care Tuesday that at first there was overwhelming support for the regulation. But then, he said, the board realized that it doesn't have authority over the doctors and HMOs that back the practice.

Jon Bunker, president of Health Plan of Nevada, defended the practice in a newspaper column in Reno Tuesday.

"By purchasing the higher dosage drugs and splitting them in half, the member, in effect, receives twice as many pills at the same price," Bunker said.

For instance, Bunker said, the anti-depressant drugs Zoloft and Celexa are both designed by the drug manufacturer to be split, evidenced by scoring, the term for the indentation on the outside of the pill that allows it to be divided in half.

Macdonald said part of the issue is what type of pill is the appropriate one to split, not only in half but in quarters. Consumers are worried the reduced pills won't be effective in treatment.

He said the HMOs are making the decision what pills to split as a cost saving. And the Pharmacy Board doesn't have any authority over that industry, he said.

The legislative committee said all facets of the medical industry should work together to come up to a solution to pill splitting.

Also at the meeting Tuesday, Janice Wright, administrator of the state Division of Health Care Financing and Policy, told the committee that 7,284 children of working poor parents are not enrolled in the Nevada Checkup insurance program.

Of that number, 3,854 are in Clark County. She said Nevada has a higher percentage of these children covered than in many other states. But the Urban Institute estimates 17,000 children qualify for this low-cost insurance in Nevada.

Wright said there is enough money budgeted to handle 11,750 children next fiscal year. She said enrollments are below estimates in every state. Parents pay a premium of $10 to $50 a quarter for coverage by HMOs of children.

Also Tuesday, Las Vegas parents pleaded with the committee for more state services for their autistic children.

"Other states have come up with the funding. Our kids are dropping through the cracks," Michele Tombari said.