Decision tool available on tablet splitting

Tablet splitting — the practice of splitting a medication tablet of a higher dosage to obtain lower dosage units — is becoming more widespread. Some patients choose to do it, and some insurers expect patients to do it. However, what might look like a cost-saving approach isn’t right for every product nor for every patient, cautions the American Pharmacists Association (APhA) in Washington, DC. The decision to split tablets must consider both the product and the patient.

Certain tablets may be difficult to split, for example. They may have coatings or be controlled-release tablets that may be impossible to split. In addition, many elderly patients may lack the skill or dexterity to split a tablet properly.

APhA’s Strategic Directions Committee (SDC), therefore has reviewed the available literature and input from practitioners regarding the impact of the splitting of tablets on patient care. The SDC developed questions for pharmacists and decision makers to consider when evaluating the appropriateness of tablet splitting for individual patients and products. The guidelines can be found in the May/June issue of the Journal of the American Pharmacists Association.

The Committee also recommends that the U.S. Food and Drug Administration and the United States Pharmacopeia study the splitting of tablets to provide data on the appropriateness of tablet splitting from a scientific basis.

Severe sufferers prefer brand name meds

As the severity of a medical condition increases, the likelihood that consumers will choose a generic medication dramatically decreases, according to a survey released at the Medco Health Solu-tions 2004 Drug Trend Symposium in Orlando, FL.

Seventy-nine percent of people would use generic medications to treat minor conditions such as a cold or the flu, and 76% of people would use a generic to treat heartburn, says a random household survey of 1,000 adult consumers nationwide conducted in April by marketing research firm ReedHaldyMcIntosh for Medco. However, only 56% agreed to use generics to treat asthma, and only 52% would use generics to treat diabetes. For treating heart disease, the number of people who would use a generic medication fell to less than 50% (47%) — despite the fact that generic medications are the medical equivalent of their brand-name counterparts.

The survey offers some insight into factors that drive brand-name use. Fifty-seven percent of respondents said they would be more likely to use a generic medication if they saw it advertised, despite the fact that generics have a lower cost. The survey also found that when presented with the same copay for using either a brand-name medication or a generic, 59% would choose the brand, while 33% would choose the generic (the remainder were undecided). As the cost of the copay rose for the brand-name medication, people were more likely to choose a generic, underscoring the importance of designing drug plans that take advantage of cost-saving opportunities for both employers and employees.

Study: Medicare drug plan is confusing to elderly

A survey released by the Kaiser Family Foundation in Washington, DC, shows that seniors are confused about the outcome of the Medicare prescription drug debate and the prescription drug law. While about two-thirds of seniors report following the debate closely, just 15% say they understand the new prescription drug law very well and almost seven in 10 don’t know that it passed and was signed into law.

The survey found that as of Feb. 8, 64% of seniors (49% of the public) said they followed the Medicare prescription drug debate very closely or somewhat closely. However, most seniors say they don’t understand the new law. Only 15% of seniors (7% of the public overall) say they understand the law very well; 24% of seniors (26% of the public) say they understand it somewhat well; and 60% of seniors (64% of the public) say they understand it not too well or not well at all.

Of particular note, 68% of seniors don’t know the law was passed by the Congress and signed by the president; 27% think the law did not pass, and 41% say they did not know whether it was passed. Some 32% of seniors correctly say the law was passed and signed. Awareness is even lower for the general public (23% say it was passed and signed).

The drug benefit will not take effect until 2006, but currently a majority of seniors have an unfavorable impression of the law. Based on their personal knowledge about the law, 55% of seniors (38% of the public) say their impression is unfavorable, compared with 17% of seniors (25% of the public) who say it is favorable. Some 28% of seniors (37% of the public) say they don’t have any impression of the new law.

Findings from the survey are available on the Kaiser Family Foundation web site at:

Applications available for safety award

The American Society of Health-System Pharmacists (ASHP) Research and Education Foundation in Bethesda, MD, and the Cardinal Health Foundation in Dublin, OH, have announced the availability of applications for the inaugural Award for Excellence in Medication-Use Safety. The award program honors a pharmacist-led multidisciplinary team that makes significant institutionwide system improvements relating to medication use. The award, the first of its kind, recognizes on a national level pharmacy professionals who have assumed a leadership role in promoting safety in the medication-use process. Applications are currently available at a dedicated web site, The applications are due by Aug. 2.

The competition will honor three finalists chosen by a panel of judges who will visit each finalist’s site this fall. The winner will receive a $50,000 award, and the other two finalists will receive $10,000 each. Primary emphasis for the award criteria will focus on achievements in the following areas: medication-use system initiative/scope, planning and implementation, measurable outcomes and impact, and innovation and applicability. The award winners will be announced Dec. 1, 2004, with presentations to follow at the ASHP Midyear Clinical Meeting in Orlando, FL, on Dec. 5-9.