Pill-splitting: It could be a big cost-saver for your prescriptions


Published: Wednesday, January 25, 2006 at 6:01 a.m.
Last Modified: Tuesday, January 24, 2006 at 11:45 p.m.
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The University of Michigan has started its pill-splitting program to save money with plans to share the savings with its health-plan members by lowering co-payments. The program is voluntary and includes three drugs that the university says can be safely split: Lipitor, Pravachol and Zocor.

Tony Ding/Detroit Free Press/KRT

Facts

Pills to safely split

Here are the other commonly prescribed drugs that top insurers list as safely splitable for saving money:

  • Aceon, hypertension
  • Atacand, hypertension
  • Avapro, hypertension
  • Benicar, hypertension
  • Cardura, hypertension
  • Celexa, depression
  • Cozaar, hypertension
  • Crestor, high cholesterol
  • Diovan, hypertension
  • Klonopin, panic disorder, epilepsy
  • Lexapro, depression
  • Lipitor, high cholesterol
  • Mavik, hypertension
  • Paxil, depression
  • Pexeva, depression
  • Pravachol, high cholesterol
  • Valtrex, herpes
  • Viagra, erectile dysfunction
  • Zestril, heart failure, high blood pressure
  • Zocor, high cholesterol
  • Zoloft, depression
  • Zyprexa, schizophrenia, bipolar disorder

  • The latest trend in cutting health-care costs? Health-care plans that encourage members to slice pills in half as a way to cut prescription-drug costs.
    As health and prescription-drug costs continue to climb, it's a practice experts expect more insurers and employers to encourage, although the drug industry criticizes the practice and stands to lose billions of dollars if pill-splitting takes off.
    A new and controversial pill-splitting program at the University of Michigan, for instance, could save $1.3 million and its health-plan members could save $190,000 this year if 45 percent of eligible members join.
    The university started its pill-splitting program Jan. 1 to save money with plans to share the savings with its health-plan members by lowering co-pays. The program is voluntary and, at this point, includes three drugs that the university says can be safely split: Lipitor, Pravachol and Zocor.
    The savings come through a quirk in the drug-pricing system that makes many prescription tablets available at the same or nearly the same cost whether patients buy them in low doses or high doses. Thirty tablets of Lipitor, for example, cost $116 at Walgreen Co., whether a patient buys 20 mg, 40 mg or 80 mg tablets.
    So a patient could buy tablets at double the dose needed, cut them in half and get two months' worth for the price of one.
    "It's very cost efficient," says Susan Blackwell, who started splitting her cholesterol medicine six months ago as part of a pilot study. "I just wish there's some way they could do it with other medicines. Anything to help keep down the cost."
    Uninsured patients, Medicare patients and others who struggle to pay for their prescription drugs have long used pill splitting to save money.
    But UM is among the early adopters of official programs that encourage health-plan members to slice pills in half.
    Drug maker Pfizer Inc. reported more than $10 billion in sales of Lipitor in 2004.
    Besides profits, the pharmaceutical industry is concerned for several other reasons: Insurers could make pill splitting mandatory, patients might mistakenly divide tablets that aren't safe to split, patients might split pills incorrectly and patients might forget to split high-dose pills.
    "Pill splitting can potentially harm a patient due to the adverse effects an incorrect and inaccurate dosage of a prescribed medicine can have on their health," said Ken Johnson, senior vice president of the pharmaceutical industry organization Pharmaceutical Research and Manufacturers of America.
    The university and other institutions that promote pill splitting concede that the process isn't right for everybody and isn't appropriate with all medications.
    For example, in the blood-thinning drug Coumadin, the difference between an effective dose and a lethal dose is very small. Some medications won't work at all if they're cut in half. And gel- and powder-filled capsules can't be accurately divided.
    "We really encourage people to work with their physicians to ensure that they indeed are good candidates," said Greg Thompson, spokesperson for Minneapolis-based insurer UnitedHealthcare, which launched a pill-splitting program last year.
    "It's very cost efficient. I just wish there's some way they could do it with other medicines. Anything to help keep down the cost."
    Here's how to save Patients ask their doctors to write prescription for 15 pills at double their normal dosage. In many cases, they'd ask for 15 40 mg pills instead of 30 20 mg pills.
    The patient uses a pill-splitting tool to avoid waste and then takes half a pill.
    In the Lipitor example, the University of Michigan pays $58 instead of $115.99.
    In the Zocor example, UM would pay $64.99 instead of $135.99.
    Knight Ridder Newspapers

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