Chopping costs by cutting pills

One in six Americans is splitting a tablet in half to lower medical costs and make prescriptions last longer.

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By Parija B. Kavilanz, senior writer

About 15% of Americans are either cutting pills in half or skipping doses to make their prescriptions last longer, according to the Kaiser Health Tracking Poll.
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Carex Health Brands sold 2 million pill splitters in 2008, up 9% over the preious year.

NEW YORK ( -- More consumers, struggling to contain medical expenses, are resorting to "pill cutting" to makes their prescriptions last longer.

And at some drug stores, pharmacists are stepping in to help cash-strapped customers get the option to split their pills.

Although the drugstore chain "doesn't advocate any one practice," Walgreens (WAG, Fortune 500) spokesman Robert Elsinger said he's learned anecdotally of many instances over the past year in which pharmacists have contacted doctors on customers' behalf for "double" dosage prescriptions of some medications.

As Elsinger explained, for many popular medications - but not all - a larger dose is often the same price as the lower dosage. He said a 40-milligram pill of the cholesterol-cutting drug Lipitor, for example, can cost the same as a 20-milligram pill.

"If the price is the same, people can cut the higher dose pill in half so they're paying less for more medication," Elsinger said.

So getting double the dosage, then splitting the pills to get twice as many 20-milligram pills, would help consumers reduce their co-payments.

The savings can be even greater for consumers who are paying out of pocket for prescription drugs.

Industry watchers say pill cutting is catching on in a tight economy as consumers, insurance providers and employers all search for affordable ways to manage rising health care costs.

About 15% of Americans, or one in six people, say they're splitting their pills in half, according to the latest consumer survey from non-profit group Kaiser Family Foundation.

As evidence of this trend, retail sales of "pill splitters," small box-shaped devices used to cut pills in half, have also increased over the past year.

Medical devices maker Carex Health Brand, one of the leading makers of the pill splitter, said it sold over 2 million of its Apex pill splitters in 2008, up 9% over the prior year.

Its Apex pill splitter, priced under $5, is sold at mass discount and drug stores such as Wal-Mart (WMT, Fortune 500) and (AMZN, Fortune 500).

"Despite a pullback in consumer spending, products like the pill splitter are generally need driven, and continued to [sell] at retail because they're helping consumers and insurance companies save money," said Nathalie Kim, vice president of marketing with Carex Health Brands.

Some large insurance companies are now favoring pill splitting because it help them save money on co-payments as well.

UnitedHealthcare (UNH, Fortune 500), for instance, offers its customers a voluntary "half tablet" program and even gives a "free" tablet splitter as incentive to sign up.

Under UnitedHealthcare's program, a doctor writes a new prescription for twice the strength and half the quantity of a medication, noting the patient's intent to split the tablets on the prescription,

Once the prescription is filled, the patient pays only half the usual copayment.

The insurer's program covers 18 popular medications, including the antidepressant Zoloft, blood pressure drug Diovan, and cholesterol-reducing drugs Crestor, Lipitor and Zocor.

Healthcare experts have mixed feelings about pill cutting.

"It's very important for consumers to know that not all pills are meant to be split," said Sophia De Monte, a registered pharmacist and member of the American Pharmacists Association.

Pills that are "scored," or have an indentation down the middle, can be split. Other medications, such as hard or soft capsules, should not be split, she said.

Even with scored tablets, De Monte said there's a risk of "uneven" cutting that can affect the efficacy of the pill.

Her best advice: "Speak to your doctor or pharmacist first. Don't split pills on your own. And see if there are other choices, like a generic drug or another lower-priced medication if cost is a concern."

For his part, consumer advocate Greg Scandlen took issue with insurance companies advocating pill splitting as a way for consumers to save on drug costs.

"Co-pay is usually $ 5 or $10. So it's not much savings anyway," he said. "If consumers are splitting pills, they should get better cost benefit."

Instead, he suggests insurance companies split half the savings with the customer. "If their pill splitting plan saves [insurance companies] 90% per prescription, they ought to reward the consumer with half that savings," he said.

And make the reward more direct to consumers. "Just send the consumer the check," he said. To top of page

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