September 06, 2004

Save Money on Meds

We've covered this before - but it always bears repeating. Pill-splitting saves money on certain medications.

A month's supply of 50-milligram tablets of the antidepressant Zoloft retails for about $86.

Unless you know a trick that can slash the price in half.

Patrick Voight, a pharmacist at the Hassig Drug Store in Kansas City, Kan., knows that cutting a pill in half can slice a sizable portion from the pill's cost. Sometimes that's just what this pharmacist orders.

Pill-splitting exploits a curious aspect of drug-pricing. Some drugs come in more than one dosage without much difference in price. That means someone taking, for example, a 50-milligram dose of a drug could buy the 100-milligram version and cut the pill--and maybe the price--in half.

Voight says physicians may not be aware of the pill-splitting option or don't mention it because they assume their patients have insurance that covers most of the cost of drugs.

���As drug costs have spiraled at a rate far greater than the overall inflation rate -- the average prescription price in the United States grew from $54.81 in
2002 to $59.28 in 2003 -- Canadian drugs have emerged as one answer. Pill-splitting is a more nuanced approach. But it's not for everyone. And it works for only a handful of drugs. But the right candidate with the right prescription, which a physician must supply, can carve an impressive chunk out of a drug bill.

There are nuances to this strategy. Once you've identified the requisite financial wiggle room, you need to determine whether the pill lends itself to division. Pills that are scored, meaning they have a shallow cut across the middle, are ideal candidates. Two slightly unequal doses that add up to 100 milligrams each day might work just fine, he said.

���An article published in the American Journal of Managed Care identified 11 drugs that can easily be divided. They drugs are
Klonopim, Celexa, Serzone and Zoloft (prescribed for depression);
Cardura (for hypertension and enlarged prostate);
Lipitor and Pravachol (high cholesterol);
Paxil (depression and anxiety);
Prinivil (high cholesterol and heart disease);
Zyprexa (bipolar disorder and schizophrenia);
Viagra (impotence).

���Although they're a tiny fraction of the prescription medications on the
market, ''A lot of them are in the top 50 (most-prescribed drugs),'' said Howard
Stark, who owns the four Stark pharmacies in town. ''You've got millions of
dollars there.''

���Because medications have many subtle features that control their function,
consulting with a pharmacist first is a must. Many medications can be undermined if cut open. Timed-released medications, for example, must remain intact.


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