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Tablet Splitting, Education on NABP Delegates' Minds

Kate Traynor

The executive committee of the National Association of Boards of Pharmacy (NABP) is reviewing several resolutions passed by delegates who attended the organization’s annual meeting in May. This year’s resolutions addressed tablet splitting, standards for electronic prescriptions, drug-formulation changes, and educational issues.

Delegates, representing the state boards of pharmacy, identified tablet splitting as a "potentially dangerous practice" that is "monetarily driven" and not in the best interest of patients. The resolution calls on NABP to oppose plans by insurers and pharmacy benefit managers aimed at forcing pharmacists to dispense medications that must be split by patients to produce the prescribed dosage.

Delegates urged NABP to work with trade organizations and FDA to ban the practice of a company retaining the brand name when a product’s active ingredient changes. The resolution would prohibit outright changes to a product’s active ingredients, such as when Caladryl, now made by Warner-Lambert, was reformulated in the mid-1990s by replacing diphenhydramine with pramoxine. Also affected would be products such as Dyazide, which was reformulated by SmithKline Beecham in the mid-1990s to change the amount of triamterene in each tablet from 50 mg to 37.5 mg. An exception to the prohibition would be allowed if the manufacturer directly notifies patients about the change in formulation.

Another resolution called on NABP to organize a task force to examine whether standards are needed to regulate the electronic transmission of prescriptions and patient information.

Delegates wanted NABP to work with the American Council on Pharmaceutical Education (ACPE) and the Canadian Council for Accreditation of Pharmacy Programs (CCAPP) to mutually recognize the two groups’ accreditation standards. If ACPE and CCAPP would recognize each others’ accredited pharmacy education programs, then NABP should work with state boards of pharmacy to eliminate the need for Canadian-educated pharmacists to pass the Foreign Pharmacy Graduate Equivalency examination before taking the North American Pharmacist Licensure Examination.

Also, to resolve the confusion as to what constitutes "live programs" for continuing education, delegates urged NABP to request that state boards of pharmacy adopt the ACPE definition of live programs. According to NABP, ACPE in 1996 defined as "live" all continuing-education programs that allow "direct interaction between faculty and participants." This means that computer-based distance-learning programs could qualify as live if the faculty and students interact in real time.