Health Insurer Encourages Pill Splitting

[jeffrey]

According to a report in The Wall Street Journal, UnitedHealth Group is offering patients up to $300 in annual prescription co-payment savings if they cut their prescription pills in half.

With pill splitting, a patient purchases pills at twice the prescribed dose and cuts them in half. Pill splitting can save money due to the way prescription drugs are manufactured and priced. Many prescription pills cost the same amount of money regardless of their dosage.




While the practice of pill splitting has long been used by uninsured patients to help reduce prescription costs, this is the first time that a health insurer is encouraging the practice with discounts. The prescription drug industry has maintained that the practice is unsafe, arguing that patients might not get the exact dose they need and some pills may not be effective if cut in half. They also raise concerns that elderly and disabled people may have trouble splitting pills correctly and thus get the incorrect dose. There are currently a number of devices on the market which have been developed to make the process of splitting pills easier and more precise.

Under the UnitedHealth program, only certain categories of pills that have been shown in published studies or other research to be safe to split qualify for the program. Patients are also required to receive permission from a doctor to split pills. This is to ensure patients who may have trouble accurately splitting pill are not allowed to do so.

[cercis]

I don't know. It seems pretty stressful to me.

I've never split a pill and I've seen the pill splitters, but it seems to be that it would be fairly inexact. Especially with the little-bitty pills. If you're off by a fraction of an inch, one pill can be 50% larger than the other pill and have your dose be 25% too high or 25% too low (give or take on percentages).

I would be extremely cautious about this. I know people do it, and I'm sure for some meds 25% either way isn't a big deal.

[Fern]

Jeffrey, do you know the date of the Wall Street Journal article? I'd like to read it in its entirety. Very interesting, and surprising.

[jeffrey]

I believe I found it in the 11/23 WSJ

[flash]

Okay, here's the expert advice.

Yes, MOST pills can be split safely, and it is REMARKABLE cheaper to use the larger pill.

Pills that can be safely split generally are pre-scored (that line down the middle), to aid in breaking the tablet evenly. Some are even easier to break with a fingernail than the pill splitter.

Your doctor can PRESCRIBE the dosage with split pills, and they will advise you if you express concerns about the costs. Your pharmacist can also inform you if you are taking a tablet that can be split, and what the cost savings will be. MOST pharmacists will assist you in arranging this, and provide splitters free of charge.

CAPSULES should not generally be split. Accuracy in dosage is much more difficult. There are also particular pills where a VERY tiny dose is used, and the error in division becomes more critical. For example, in general, a seizure medication such as Lamictal should not be split without approval from your doctor. The dose must be administered exactly 12 hours apart, and the dose must not vary by more than 2 mg. That is one of the reasons the larger pills are cheaper, 100 mgs. of Lamictal is easier to make within 1% accuracy than a 25mg pill is. 30 tabs of 25 mg Lamictal is aroudn $300, while 30 tabs of 100mg lamitcal is around $300.

BOTTOM LINE, ask your pharmacist about splitting and savings. Tell your doctor if you are.

[katwoman]

I attended a seminar at a highly respected medical center where people are now being counseled to split pills and even to go ahead and buy medication from Canada and the UK.

Medicare is giving the green light on all this. I've got an elderly mom so I needed to know what's allowed under the new Medicare Rx plans. Wait till you see what awaits the elderly! This president has royally screwed everyone.

[flash]

My Mom is doing the same thing, I'm trying to sort out her Medicare Part D while she gets her drugs from Canada. Is Medicare going to cover Canadian drugs, because my understanding was they were not. The specific insurance plan you chose may determine coverage.

If you are trying to track the "coverage" of Canadian drugs under Medicare, note that most Canadian drugs are sold under their generic names, but the American generic and Canadian generic are still under different standards. Also, many have their own "canadian brand" generic names which don't appear in the Medicare formulary unless you cross reference back to the American counterpart drug.

[katwoman]

This seminar was given in conjuction with the medical center's Geriatric counseling division and a non-profit social services agency that is focused on the elderly.

You're right that each plan can limit where you buy your drugs, but at this seminar it SEEMED that the Canada/UK option was fine. In fact, it was the very first thing they threw out and looked like they WANTED it to sink in.

Whether or not those drugs are covered is hard to tell. I guess if you take few medications it would be worth it to go this route rather than pay premiums and deductables. KWIM? They were trying to give as many options as they could. These Medicare D plans are not broadly based. They're individually based given your personal circumstances. It is possible that a husband and wife will need to get separate plans given their drug needs. That is, if they know all their options.

I'm fortunate enough to be able to sit down, one on one, with a social worker at this geriatric center and decide which plan is good for my mother given her individual needs. FOR FREE! A great many others are not so lucky. Many elderly folk will be too overwhelmed and even financially disadvantaged by these Medicare D programs. It's a mine field unless you know how to navigate it.

Like I said, Bush really gave our people the BIG ONE! I hope he burns in Hell!

[flash]

I found this site REALLY helpful, although it is swamped right now:

Medicare MDPDF

It's the medicare prescription drug plan finder. You have to put in ALL your meds and other info, and it will go through available plans and find ones that fit your needs the best.

If you can't get to that link, try
http://www.medicare.gov

and just get to the links from there.

Hope it helps!