Pill-splitting can yield cost savings on common prescription drugs, Stanford researchers find

STANFORD, Calif. - Squeezed by the rising cost of prescription drugs, health plans and other health-care organizations are pursuing cost-saving strategies such as encouraging the use of generics, using narrowly tailored drug formularies and implementing multi-tiered co-payment systems.

Now, researchers at Stanford University Medical Center have confirmed that a less-common strategy - pill-splitting - could yield significant cost savings without compromising drug efficacy or safety. They emphasize that pill-splitting must be implemented with careful controls and begin with a doctor-patient conversation.

"When properly implemented, pill-splitting can be a safe, viable cost-saving strategy," said Randall Stafford, MD, PhD, a researcher at the Stanford Center for Research in Disease Prevention and lead author of an article published in the August issue of the American Journal of Managed Care. "Physicians should consider using pill-splitting with selected medications and patients, and patients may want to bring it up with their doctors."

Many prescription drugs are available at increased dosages for the same or similar costs as smaller dosages. When physicians prescribe half as many higher-strength pills and have the patient split them to achieve the desired dosage, the cost of certain medications can be reduced as much as 50 percent.

Using pharmacy claims data from a commercial managed-care plan in Massachusetts, Stafford and colleagues examined how often pill-splitting was used. They found the practice was relatively infrequent, accounting for annual savings of $6,200 in the health plan.

Researchers then used a systematic screening process to determine which medications were appropriate for pill-splitting. Starting with the 265 medications most commonly prescribed nationally and within the specific health plan, they narrowed the list in stages. First they eliminated drugs that came prepackaged, weren't available in tablets or were a

Contact: Sara Selis
Stanford University Medical Center

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