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HMO Forcing Members to Split Anti-Depressant
Pills to Cut Costs

Associated Press
RALEIGH, N.C. — In a move aimed at offsetting rising drug prices, one of the nation's leading HMOs is forcing members to split a large pill of some anti-depressant pills in half in order to get their daily dose.

Critics, including some doctors, say the action by UnitedHealthcare takes penny-pinching by health maintenance organizations to new extremes and say it could be dangerous.

"It comes across as very cheap on the part of the health plan," said Dr. Ian Bushell of Family Medicine Associates of Cary. "It's not so much a hassle for me. The patients are the ones who have to break a pill in half."

United says it will pass along its savings by keeping premiums low.

United recently sent letters to doctors, members and pharmacies outlining the new nationwide policy.

The HMO now says it won't pay for certain dosages of Zoloft, Paxil and Celexa, three popular anti-depressants. For example, it no longer will cover 50-milligram tablets of Zoloft, a commonly prescribed daily dosage. Instead, the HMO will cover 100 mg tablets and order doctors to prescribe half a pill per day.

A 100 mg pill of Zoloft costs 7 cents more than a 50 mg pill, according to Dr. Lee Newcomer, senior vice president for health policy with United.

Covering only 100 mg tablets and having patients split them will lower the cost for the same amount of medicine significantly, he added.

A 30-day supply of the equivalent of 50 mg per day, under the new policy, will cost United $36.15, down from the $70.20 it pays now.

"It seemed to be a painless way to keep drug costs down," Newcomer said.

Daniel Garrett, executive director of the N.C. Association of Pharmacists, said smaller HMOs have tried similar policies, but this is the first time he has heard of a national HMO requiring it.

"For some patients, you could end up with dosing errors," Garrett said.

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