In fact, for many individuals, this technique has literally halved the cost of prescription drugs – for themselves and for their employer. So successful is the pill splitting strategy in generating dramatic cost savings that many of the country’s largest and most influential benefit carriers have begun to require the use of the device for specific medications. Kaiser, Humana and UnitedHealth have each unveiled such a program and others, including many state public health programs, are rapidly following suit. Should you?

For many of the most commonly prescribed medications, the cost of the double strength dosage is frequently less than 20% more expensive than the standard dose. And, often, the costs are identical. If that medication is “splittable” (meaning: is it in tablet form that can be effectively divided into two equal halves), the logic of the strategy is unassailable – two-for-the-price-of-one! Moreover, since the cost of the prescription is frequently borne in large measure by the employer – through the prescription drug program – the savings are realized to both the employee (by paying only one-half of their normal Rx co-pay) and the employer (saving as much as one-half of the average wholesale price of the medication itself). That’s the very definition of a win-win!

In a recent survey of members, more than 91% of UnitedHealthcare members indicated they would be comfortable splitting pills and physicians too expressed their satisfaction with the process. In fact, over 70% of those surveyed expressed a positive perception with many indicating they had been engaging secretly in the practice for many years in an effort to reduce the costs for their patients.

How much can be saved under a pill splitting program? Participants in the United Healthcare study saved as much as $300 per year in co-pays alone. Employers, who were footing most of the expense as premium charges, were saving thousands. In a frequently cited study at Stanford University, the savings amounted to an average overall savings of 36% in the cost of the drugs dispensed.

“But what about the safety issues?” is often the reply. And, for certain populations this strategy may be inadvisable. Those whose specific condition may preclude them from using the splitter properly are not candidates for this program. For instance, those afflicted with arthritis or weak eyesight may not be able to engage in the program effectively. And, of course, there are certain medications that should never be split (see table below).

WHICH DRUGS SHOULD NOT BE SPLIT?

• Timed or extended release
• Narrow therapeutic index drugs – where the toxic dose is close to its therapeutic dose
• Tablets with protective coatings
• Combination pills having multiple therapeutic functions
• Tablets that easily crumble