Notes for your Drug Plan - Pill Splitting and Ambien Warnings...

Two new considerations for your Rx program from recent issue of BusinessWeek:

1.  Pill Split Programs:

"For years some patients have been saving money by splitting high-dose versions of prescription drugs in half: While 30 20-mg tablets of Lipitor, Pfizer's (PFE ) best-selling cholesterol-lowering statin, might cost $116, 15 40-mg pills can cost just $58.

Not all pills can be safely split. But a new study from the University of Michigan finds that bisecting statin tablets has no adverse effect on patients' cholesterol levels. (Small fluctuations in levels aren't dangerous.)

The six-month study, reported in the June issue of the American Journal of Managed Care, followed 111 patients taking one of three statins: Lipitor, Bristol-Myers Squibb's (BMY ) Pravachol, or Merck's (MRK ) Zocor, the world's biggest-selling drugs. Without knowing how common pill-splitting is now, analysts say they can't estimate the financial impact of its becoming the norm. U-Mich started a pill-splitting plan for 500 of its employees and retirees last year, saving $195,000 in prescription drug coverage so far. Enrollees have saved a total of $25,000."

2.  Making Employees aware of warnings with common lifestyle drugs:

"Even when government regulators raise alarms about safety, lifestyle drugs often prove irresistible. Millions of Americans, for example, routinely pop sleep medications, even though they are rarely troubled by insomnia, and the crutch is hard to give up. Last year several users of Ambien, from Sanofi-Aventis, reported bizarre incidents in which they consumed meals and drove their cars while asleep.

The FDA demanded that Sanofi and all other producers of sleep drugs add strong warnings to their labels. In March the agency further requested that they send letters to doctors notifying them of the warnings and that they print guides for patients that describe the side effects and provide advice on how to use the drugs safely. Undaunted, Americans consumed more than $700 million worth of Ambien in the first quarter of this year, a 54% jump over the same quarter in 2006. All told, prescriptions for Ambien, Sepracor Inc.'s (SEPR ) Lunesta, and similar drugs jumped 15% last year, to 47.8 million, according to health-care information provider IMS Health Inc. (RX ), and total sales grew 29%, to $3.6 billion."

My reaction?  I continue to be amazed how Drug companies can create entire markets out of vapor.  To be sure, there are some folks who get real benefits out of Ambien, but a 54% increase?  What would the numbers be with proper distribution of the warnings?  How do we attack that as HR people?  Good questions needing more exploration.

Pill split program is interesting as well - I'll be looking for more info on how that works, since it seems like it would require a fair amount of administration, focus on saftey, etc...

Comments

[Laurie Ruettimann]

It's no wonder that there is a rise in prescriptions for Ambien when we think about the rise of obesity, sleep apnea, working remotely, the virtual office, and crackberry addiction. Sleep is for the weak, right?

[Alan]

We are becoming more dependent on taking pills for our ills. It isn't surprising considering that the pharmaceutical companies have a lot more money and clout than do those groups that promote exercise and wholistic medicines.

We could all stop taking medications if we put more effort into eating right, exercising and getting enough sleep, but as the previous commentor suggested, "sleep is for the weak". So instead, we all take our little pill (as the Rolling Stones would say) to get us through our day or night.

Too bad we don't take a stronger stand against the pharmaceutical companies. They promote the drugs, our doctors prescribe them and we become dependent on them. There aren't many of us out there (besides Tom Cruise) who are promoting wellness rather than taking drugs for the ills that plague us.

Imagine how many people could wean themselves off of Ambien and Zocor by exercising more? Instead, we feed the revenue streams of the drug companies who suggest we continue with our stressful lives and take their little red, white and blue pills to get by. Maybe with a little less dependence on them and a little more responsibility for ourselves, we could have things turn out differently.

[John]

This is the direct result of pharmaceutical advertising on mainstream media. Rogaine was the first Rx that advertised and acheived record results. Now, people who have one night's bad rest will go into the doctor's office and request Ambien by name and swear up and down that they can't sleep. Don't get me wrong, it's not limited to Ambien. The industry has created a patient base that tells the doctor what treatment they need, rather than letting the doctor tell them what they need. Advertising prescriptions in the mainstream media needs to be eliminated, it should be limited to publications intended for the medical community.

[Blake Hamby]

Since this is my first experience in "blogging" I am going old school here with a stream I found from July. I agree with Alan in that we could all benefit from a lifestyle that promotes the right diet, exercise, and rest. Not only would this change in lifestyle allow us to live healthier lives, it should prove to provide us with more energy and focus while we are at work! This goes back to the old adage, "work smarter, not harder."

However, we do live in a society that fosters the belief that "sleep is for the weak." There was a very interesting survey shown in the latest addition of Employee Benefit News that strengthens the argument that the US does not believe in rest. The survey showed the "Guaranteed number of paid holidays" and the "Statutory minimum number of paid vacation days" for several countries. The US is the only country to score a zero in both categories. While I do not agree that we need to adopt France's policies and provide a mandatory 30 days of paid vacation and one holiday a year, I do think we can benefit from a little more focused effort on rest and rejuvenation. You can view the survey on page 51 of the following link http://ebn.benefitnews.com/attachment-cache/pdfs/ebn/issues/EBN.03.08.pdf

I completely agree with hard work and believe that we are, as human beings, made to work. I just believe that we could all benefit from a more balanced life and still maintain the level of productivity that we are known for in the US. I mean, even God rested one day of the week.