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The complaint, filed in California Superior Court in Oakland, seeks a court order barring Kaiser from forcing members to split pills and requiring it to forfeit all "illegally-gained profits" stemming from the pill-splitting policy. The lawsuit was filed by Trial Lawyers for Public Justice (TLPJ), a public interest law firm representing more than 2,200 trial lawyers. "Kaiser's mandatory pill-splitting policy is an outrageous example of an HMO valuing its profits over its members' health and safety," said Arthur H. Bryant, TLPJ's executive director and co-counsel in the case. Kaiser makes millions on pill-splitting, a practice that has no therapeutic benefits and puts patients' health at risk, he charged. When pills are not split evenly, overdoses and under-dosages can result, and experts acknowledge that it is not always appropriate to cut certain medications. Cutting pills can be particularly difficult for elderly patients who suffer from hand tremors, visual problems or dementia, which is why the American Society of Consultant Pharmacists took a stand this summer against health insurance policies that require patients to split tablets of medication to save money. Dr. Charles Phillips, a plaintiff in the case, cites evidence that pill-splitting is risky business. As a contract physician in a Kaiser hospital emergency room, he discovered that many patients with hypertension, heart attacks and strokes had been receiving uneven dosages of their blood pressure medication because Kaiser told them to split pills. Kaiser issued a statement in which it explains that pill-splitting is voluntary and that, for patient safety reasons, it has guidelines for determining which medications may be appropriate to split. "We only recommend pill-splitting for patients who are able and willing to do so," it said. But according to plaintiffs in the case, that is not what really happens. "In fact, patients are not given a choice about whether they want to split their medications, but are simply provided the double-dose medications and a pill-splitter, often without direction or instruction," according to the suit. Even when patients or doctors object, Kaiser's pharmacists or pharmacy managers often refuse to dispense the drug in single-dose form, the suit alleges. The complaint goes on to suggest that the only reason for requiring patients to split their medication tablets is to increase Kaiser's revenue and its professional management's bonuses. The lawsuit gives examples of how that alleged profit motive is realized. The blood pressure medication Prinivil, for instance, costs $100.25 for 100 20-mg tablets but just $143.53 for the same number of 40-mg tablets. So by dispensing the higher-dosage tablets and requiring the member to split the pill to make 200 20-mg doses, Kaiser makes a profit of $56.72. The same is true of the popular antidepressant Zoloft, the plaintiffs allege. Kaiser can boost its profits by $220.58 on a script for 100 tablets by having patients cut 100 mg pills in half. "The real issue today," counters Kaiser, "is the skyrocketing cost of pharmaceuticals that too often puts life-saving medications beyond the reach of many patients." Kaiser said that pill-splitting can help people afford drugs without hurting the quality of care. |
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Last modified: March 30, 2007 |
