With the escalating cost of prescription drugs, patients and insurers alike are looking for relief. A new program initiated by UnitedHealthcare could potentially cut costs – and pills – in half.
The insurer’s Half-Tablet Program gives patients the opportunity to save money on certain prescription drugs by splitting their pills in half. So, instead of taking a full 20 mg tablet, a patient can take half of a 40 mg tablet for about half the price.
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For example, on drugstore.com, 30 Paxil 10 mg tablets cost $74.99. The same number of 20 mg tablets cost $86.19. This means that a consumer can purchase double the supply for less than $12 more.
Debora Spano, Northeast communications director for UnitedHealthcare, said a pilot for a voluntary pill-splitting program began in Wisconsin in June. The program is expected to go nationwide in January. In Fox Valley, Wis., where 80 percent of the 150,000 eligible members participated in the program, savings for the year were projected to be $800,000.
The program is “completely voluntary,” Spano said, noting that a physician must write a prescription for a higher dosage with the intent to split them. There are 15 medications safe to split as part of the program including Lipitor, Zoloft and Zocor.
“A slight variation won’t affect the efficacy of the drug or the health of the individual,” said Spano.
This program is especially important after a study from the Kaiser Family Foundation in November said retail prescription prices increased an average of 8.3 percent per year from 1994 to 2004, more than triple the average rate of inflation. The share of prescription drug expenses paid by private health insurers increased from 24 percent in 1990 to 46 percent in 2003, according to the study.
An earlier study by the U.S. Department of Veterans Affairs reported a savings of $46.5 million in 2003 by having 1.1 million eligible patients split Zocor in half.
Kristina Ward, director of drug information services and clinical assistant professor in the college of pharmacy at the University of Rhode Island, said pill splitting is a potential way to save money, and it has been used for a long time as a way for uninsured patients to afford medications they otherwise would not take.
But for people with a complex medicine regimen, like the elderly, it may be difficult to manage, she said. In addition, there are risks for certain medications. The National Association of Chain Drug Stores (NACDS) in Virginia wrote in a November 2004 report that narrow therapeutic drugs – medications whose toxic dose is close to its therapeutic dose – are vulnerable to even small variations in dosages. Additionally, drugs with coatings or time/extended-release medicine could be ineffective or harmful if split, according to the report.
“Exact pill splitting is impossible,” the NACDS report said. “Tablets are manufactured to be dispensed and consumed in the same form as when they leave the manufacturer.”
Denise Ulrich, director of public affairs at Merck, manufacturer of Zocor, said the company does not recommend pill splitting because it is difficult for a patient to get the prescribed dosage when they manually split a tablet. Merck has not evaluated the efficacy or tolerability of Zocor after it has been split, she said.
Representatives at Pfizer, manufacturer of four commonly split pills: Zoloft, Viagra, Lipitor and Cardura could not be reached for comment.
Carmen Reitano, director of technology development at Precision Pill Splitters (PPS) in Newburyport, Mass., said drug companies created odd-shaped drugs to obstruct pill splitting.
PPS first developed a pill splitter for Viagra, he said. The company then created the first drug-specific and installable pill beds to make it safer and easier to cut, said Reitano. Currently, the company is working on a tool to quarter pills, he said.
The prescriptions being split are not volatile drugs, according to Reitano, and there can be a 15-percent variance in dosage before there is a health risk.
Kim Keough, assistant vice president of public relations at Blue Cross & Blue Shield of Rhode Island, said via e-mail the company understands that pill splitting is practiced industry-wide, but does not have a position at this time.
