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           Cialis Pill Splitting for Considerable Savings
        
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The following represent articles that address the topic of pill splitting, save money by buying the larger doses of medications and then splitting the pills:

An Easy Remedy: Cut Your Drug Bills in Half by Cutting Pills in Half
Wall Street Journal
February 2009

Save Money On Prescription Medications
Consumer Reports
January 2009

In Cutting Drug Costs, Cooperation Is Key
Martin F. Downs, Medical Writer
February 2009

Helping Patients Avoid Hard Choices
Managed Care
January 2009


An Easy Remedy: Cut Your Drug Bills in Half by Cutting Pills in Half
Wall Street Journal
February 2009

Looking for ways to cut your prescription drug costs? Try buying bigger pills and cutting them in half.

Pill splitting is a deceptively simple way to save money on drugs, but few consumers or even doctors are aware that it's an option. A quirk in the way drugs are manufactured and priced means many drugs cost about the same per pill, regardless of the dosage. As a result, patients who buy a larger pill that contains twice the dose they need can cut it in half and save as much as 50 percent.

For example, Merck's cholesterol-lowering drug Zocor costs about £2.94 a pill, whether the dose is for 20 milligrams or 40 milligrams. A patient who needs a 20-milligram daily dose can cut a 40-milligram pill in half, dropping the cost to just £1.57, saving more than £700 annually.

A patient who needs a 75-milligram daily dose of Pfizer's antidepressant Zoloft would pay £6.66 to take three 25-milligram pills. But splitting a combination of 100-milligram and 50-milligram pills to achieve a 75-milligram dose lowers the cost to just £2.53, a savings of 62 percent — or more than £1,500 annually. Given that many older, uninsured patients have several prescriptions, the annual savings from pill splitting can add up to thousands of dollars.

A typical 10-milligram dose of Lilly's Cialis costs £12.20, close to the same price as a 20-milligram pill. Splitting the larger Cialis pill lowers the price to just £8.10 a dose.

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Even Dr. Rogers advises that certain drugs for serious conditions, such as those that prevent seizures or regulate heart rhythm, shouldn't be split.

But it's the way pharmaceutical firms manufacture and price their drugs that makes pill-splitting possible. Many pills are "scored" — manufactured with an indented line down the middle — for the sole purpose of allowing them to be cut in half. Drug firms score pills to give doctors flexibility to adjust a patient's dosage.

Finally, many drugs are flat priced — meaning they cost the same whether the dose is 50 milligrams or 100 milligrams. Drug firms do this because they want patients to get the most effective dose, and they don't want cost to be a factor when doctors are deciding how much of a drug to prescribe.
The result is a pricing loophole that gives patients a chance to dramatically cut their drug costs. Last year, 80-year-old Marion Budny of Grosse Ile, Mich., spent
£2,400 on seven prescription drugs. On the advice of Dr. Rogers, she will now split larger doses of the drugs Lipitor, Cozaar and Norvasc for an annual savings of about £700 off the national retail price. "Anything I can save will be a big help," she says.

Although some patients may worry that splitting pills will result in an uneven cut and a dose that is slightly high or low, Dr. Rogers says those variations rarely matter.

"There's a lot of room to play with," Dr. Rogers says. "The drug companies all say this is very specific, but there's a little less science involved than what everybody is led to believe -- split the larger dose and save money."

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Save Money On Prescription Medications
Consumer Reports
January 2009

When you shop for renewable prescriptions and non-rush orders, get prices from a variety of retailers, including independent pharmacies and pharmacies at supermarkets and mass-merchandise stores such as Costco Wholesale. When you call, be prepared with the name of the medication, the pill count, and the strength in milligrams (mg.).

But that's not the only way to save.

Once a year, bring all your drugs and nutritional supplements to your pharmacist and physician so they can suggest any less expensive alternatives. Sometimes inexpensive versions--including generics or older, well-established drugs--work as well as newer, higher-priced drugs. The doctor's review should focus first on whether you still need all your medications. It's not unusual for a person to start taking a drug such as a tranquilizer for a specific symptom and to keep taking it even when it's no longer necessary.

Ask your doctor for free samples, especially if you need a one-time supply of a drug for, say, a bacterial infection. But avoid samples for chronic conditions if it means continuing on a costly new drug when cheaper, effective alternatives are available.

You can sometimes cut costs by asking your doctor to prescribe a drug at double dose so you can divide the tablets at home with a pill splitter. For instance, both the 10-mg. and 20-mg. pills of lisinopril (Prinivil) for high blood pressure cost about £27 for a 30-day supply. If you need only 10 mg., you can buy the 20-mg. version and cut the pills in half, saving £15 per month. But not all pills can be split without compromising their effectiveness.

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In Cutting Drug Costs, Cooperation Is Key
Martin F. Downs, Medical Writer
February 2009

We all know prescription drugs prices can be astronomical, and it doesn't look like they'll be coming down anytime soon. There are plenty of clever ways to shave dollars and cents off the cost of your medications, but experts say that simply cooperating with your healthcare provider can save you--and everyone else in the United States--more money than any gimmick can.

Perhaps the most popular way to save money on prescription drugs is pill splitting. The concept is simple, and it seems like an excellent idea: The price of many drugs is the same at a higher dose as it is at a lower dose. So you buy your medication at two times the dose you need, then cut the pills in half, and save 50%

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But this "two for one" deal is not for everyone. First of all, there are many medications you absolutely cannot split. These include time-release and coated pills, capsules, and any pill that is not scored down the center. What's more, the practice has inherent hazards. "It's extremely unwise in my opinion," says Frank Ascione, associate professor of social and administrative sciences at the University of Michigan College of Pharmacy. "The logistics involved in doing that are pretty problematic."

If your hand is unsteady and you'd rather not put your fingers in the way of a razor blade, you can buy a special pill splitter at your local drug store. But even if you use this device, you have to ask yourself if you trust your memory. Popovich says many people, especially the elderly, forget to cut the tablet in half and overdose.

Ascione says some healthcare plans advise people to practice pill splitting. "A number of managed-care companies are jumping on that bandwagon," he says.

Alan Korn, MD, chief medical officer for the national network Blue Cross Blue Shield, says his organization doesn't recommend it. "I know of no Blue Cross plans that incorporate pill splitting in any of the advice they give," he says. "It's a patient-driven decision, not a plan-directed one."

But Dr. Korn says he thinks there is one drug that's okay to split: Cialis. He says people who take Cialis don't have to follow a strict dosing schedule. If they split the tablets, "so what?" he says. "They spit the Cialis 20 mg tablet into two 10 mg doses, and that's fine."
 

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Helping Patients Avoid Hard Choices

Managed Care
January 2009

There are ways for low-income groups to avoid paying top dollar for prescriptions. Here's one way physicians can educate consumers.

Drug expenditures have been increasing at an annual rate of about 15 percent — faster than other components of health care spending. They account for 8 percent of health care spending overall, but 10 percent of seniors' health care expenditures. According to a study by the University of Minnesota College of Pharmacy, annual spending by the elderly for prescription drugs increased by 116 percent between 1992 and 2000, rising from £559 to £1,205 per person. Meanwhile, overall health care spending per elderly patient increased by 59 percent.

Although it could be argued that increased drug expenditures have helped hold overall health care costs down, it nevertheless is true that people on fixed or low incomes are in a financial bind. Their predicament is likely to worsen, as more drugs (and more expensive drugs) become available. In 1992, the average older American received 19.6 prescriptions annually at an average cost of £28.50 each. By this year, it is expected that the elderly would receive 28.5 per person (average cost, £42.30), and by 2005, 34.4 per person — at an average cost of £55.54.

The opposing handout, which you may want to photocopy, provides information for budget-conscious patients. Information about assistance provided by states and pharmaceutical companies is readily available online. Remind patients who don't have a computer that many public libraries provide free Web access, along with assistance in using the computer and searching for information.

Prescribing a generic product instead of a branded one may help patients save money. The Generic Pharmaceutical Association claims that every 1 percent increase in generic drug use results in savings of £1.16 billion. Generic drugs account for more than 40 percent of prescriptions nationwide but less than 9 percent of drug expenditures.

If a branded product is essential, the manufacturer may be able to provide the drug free of charge. Member companies of the Pharmaceutical Research and Manufacturers of America (PhRMA) maintain an online directory. The alphabetical list of companies provides products available, instructions for making requests, and eligibility criteria.

How To Save Money on Prescriptions

Who doesn't want to save money on prescriptions? Look below for some suggestions. You can use the Internet to get telephone numbers and other details about assistance programs provided by states and pharmaceutical companies. If you don't have a computer, your public library should be able to help you, free of charge.

First-tier products -if you belong to a managed care organization (MCO), ask your doctor to prescribe a drug on the "first tier" of its formulary (list of preferred drugs). That drug is likely to be a generic product provided at no or very low cost. Drugs on the second and third tiers involve copayments that can be substantial, especially for products on the third tier.

Mail order pharmacies - mail order pharmacies can provide substantial savings over the cost of prescriptions filled locally. Be sure to order only products that your doctor says you'll use for a long time. Otherwise, if your doctor changes or stops your prescription, you'll waste money. If you belong to an MCO, you already may have received information about ordering drugs by mail. Otherwise, you can go online to find mail-order pharmacies.

Pill splitting - it may be cheaper to split, say, 100-milligram tablets in two than to buy 50 milligram tablets. Ask your pharmacist about inexpensive pill-splitting devices, and whether it is safe to split a given product.

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