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News > Companies
HMOs urge 'pill chopping'
March 22, 2000: 5:46 p.m. ET

Patients encouraged to split high-dose prescriptions to save money
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NEW YORK (CNNfn) - Several big health maintenance organizations are encouraging patients to cut some types of high-dose medicines in half to save money, as part of an effort to rein in rising prescription drug costs.
    HMOs including United Healthcare Corp. (UNH: Research, Estimates) and Foundation Health Systems (FHS: Research, Estimates) urge patients who take popular antidepressants to get prescriptions for higher-dose medications, then chop the pills in half to create twice as many tablets. Higher-dose tablets often cost essentially the same price as smaller pills, so the pill splitting saves money, the HMOs say.
    Kaiser Permanente also promotes the practice for a wider range of medications including some antibiotics and hypertension drugs.
    However, some pharmacists and consumer advocates fear that patients could be at risk if they do not split the pills correctly or forget to cut them in half. Many drug makers, who stand to lose sales due to pill splitting, also oppose the practice.
    
Rising health care costs

    For HMOs, the soaring price of prescription drugs over the past few years has left them struggling to control costs. HMOs have adopted many programs to try to battle skyrocketing pharmaceutical spending, including new limits on the choice of drugs they cover.
    Earlier this month, United Healthcare began encouraging patients who take the antidepressants Zoloft, made by Pfizer Inc. (PFE: Research, Estimates), Celexa, manufactured by Forest Laboratories (FRX: Research, Estimates) or SmithKline Beecham's (SBH: Research, Estimates) Paxil to consider pill splitting. (The widely prescribed antidepressant Prozac, made by Eli Lilly and Co. (LLY: Research, Estimates), cannot be safely split because it is manufactured in capsule, rather than tablet form, United Healthcare said.)
    The Minnesota-based HMO offers patients who take these antidepressants a $15 discount on their prescription drug co-payments if they agree to get a prescription that requires them to spit pills.
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    "If you could get twice the dosage at the same price, why not do that?" said Roger Cruzen, a United Healthcare spokesman.
    "People who are smart consumers ... are going to take a look at this and say 'I can save some money if I do a little extra work here.' "
    For example, the wholesale price of Celexa, is about $2.05 for a 20-milligram pill, compared with $2.10 for a 40-milligram version. Retail prices cost about 20 percent above wholesale.
    While United Healthcare's system is voluntary, California-based Foundation Health Systems has a policy of asking doctors to prescribe larger doses of antidepressants that patients then can split in half.
    People who are elderly, frail or who have sight problems are exempt from the practice, said David Olson, the HMO's senior vice president of investor relations. But for all other patients, splitting pills is a small price to pay for deeply discounted drugs received through HMO prescription drug coverage, he said.
    "Our view is that the pharmacy benefit is an extraordinarily good benefit," Olson said. "Many of these drugs cost more than $100 at retail for a month's supply. Virtually all of our members will be paying between $10 and $15."
    But some consumer advocates are wary of the practice.
    "This is not a great practice," Judy Waxman, spokeswoman for consumer advocacy group Families USA told the Associated Press. "I don't think patients should try this."
    Kenneth Goodman, the president and chief operating officer of New York-based Forest Laboratories, also opposes pill splitting by patients.
    "Tablets don't split exactly. They crumble. They don't break perfectly evenly," he said. He said that pills are scored so that they can be cut easily when necessary, but such a practice should be "something that a pharmacist with a tablet splitter can do exactly" rather than by a patient.
    But Kaiser spokeswoman Beverly Hayon said the practice was sound.
    "The idea that patients are being put at risk is absurd, and nobody wants to do that." Back to top
    -- staff and wire reports

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Most stock quote data provided by BATS. Market indices are shown in real time, except for the DJIA, which is delayed by two minutes. All times are ET. Disclaimer. Morningstar: © 2018 Morningstar, Inc. All Rights Reserved. Factset: FactSet Research Systems Inc. 2018. All rights reserved. Chicago Mercantile Association: Certain market data is the property of Chicago Mercantile Exchange Inc. and its licensors. All rights reserved. Dow Jones: The Dow Jones branded indices are proprietary to and are calculated, distributed and marketed by DJI Opco, a subsidiary of S&P Dow Jones Indices LLC and have been licensed for use to S&P Opco, LLC and CNN. Standard & Poor's and S&P are registered trademarks of Standard & Poor's Financial Services LLC and Dow Jones is a registered trademark of Dow Jones Trademark Holdings LLC. All content of the Dow Jones branded indices © S&P Dow Jones Indices LLC 2018 and/or its affiliates.