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Procedure Is to Be Used On Individual Packages
By SCOTT HENSLEY , Staff Reporter of THE WALL STREET JOURNAL
January 15, 2003 - Pfizer Inc., in a bid to reduce medication errors, said it will begin printing bar codes on individually packaged pills used in hospitals.
The move is the most comprehensive by a major pharmaceutical company to make medicines used in hospitals compatible with computerized systems to assure that a patient is getting the right medicine in the right strength at the right time.
Medication mix-ups are common and may contribute to more than 7,000 deaths a year in the U.S., according to a 1999 report on medical errors by the National Institute of Medicine.
The precise number of medication mistakes is unclear, but it is expected that the problem can be greatly reduced by computerized systems, available in some hospitals, that allow a nurse to check the dosage at a patient's bedside before administering the drug.
By year end, Pfizer expects each dose of all 30 medicines it sells in blister packs for hospital use to feature a bar code and text that identify the medicine, its dosage, lot number and expiration date.
Drug makers have been slow to add the information in computer-readable form to individual medicine packages, citing the added expense and lack of a uniform standard for encoding the information. Further, only 10% to 15% of hospitals, by some estimates, have invested in technology to use bar-code systems to reduce medication errors. Besides the cost of equipment, those hospitals now must generate their own special labels to stick on medicine cups or envelopes because drug makers generally do not.
"It's been a chicken-and-egg problem," says Byron Bond, director of trade operations for Pfizer, which is based in New York. Hospitals have been reluctant to invest in expensive computers systems when standards for drug coding haven't been set, and drug makers haven't seen the demand for coding in the absence of installed error-reduction systems.
Pfizer said it was able to tap existing printing technology to apply the codes at little additional cost, though it didn't disclose how much it spent. The company elected to use a bar-code standard called RSS14, developed previously by the Uniform Code Council, a nonprofit organization. Mr. Bond said that coding plan seems to be the leading candidate for the task and believes Pfizer's decision to proceed will encourage hospitals and others in the drug industry to follow.
Pfizer's plan comes as the Food and Drug Administration is considering a rule requiring the drug industry to apply bar codes to medicine packaging that would include information about dose, lot number and expiration date. Besides reducing errors, the codes would simplify recalls, investigations of adverse events and the purging of expired medicines from inventory.
Keith Horner, pharmacy director at St. Alexius Medical Center in Bismarck, N.D., has seen the Pfizer bar code and said that he believes it will work, though it poses some technical challenges for his hospital's current computer system. The Pfizer bar code has "got a lot more information on it than bar codes that we currently make or that have come on products that already have bar codes," he said.
He welcomed Pfizer's initiative but is concerned that the "industry provide a consistent bar code" for all packages and across all manufacturers. Pfizer's Mr. Bond believes the company's initiative will "build a grass-roots standard" and be adopted by others. Abbott Laboratories, Abbott Park, Ill., is 90% finished with a program announced before Pfizer's to add bar codes to individual units of intravenous solutions and injected drugs. But the Abbott labels don't include information about expiration date or lot number.
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