Major insurer pushes
pill-splitting savings

Pharmaceuticals balk at practice
But Pfizer Inc., the maker of Lipitor and Zoloft, disputes that finding. Splitting a pill and leaving it in a steamy bathroom, for example, could change the nature of the drug, said the company’s Dr. Mark Horn. It amounts to an “unlabeled use of our medicines” that has not been rigorously tested, Horn said.

“An experiment is being conducted on the people who are being encouraged to pill-split.”

The Federal Drug Administration does not regulate pill-splitting, but says there are risks such as forgetting to split pills, slicing time-release pills or unevenly breaking ones for which a precise daily dosage is needed.

It is crucial to have the consent of a doctor, said Tom McGinnis, FDA’s director of pharmacy affairs. Doctors can judge whether a patient is capable of splitting pills, or whether they are likely to forego taking their medicine if they feel it’s too expensive.

“The important thing is for patients to get a dose of their medication, and if it’s the only way they can afford to be on a statin (cholesterol-reducing) drug, I think a doctor would think that was reasonable,” McGinnis said.

High costs putting patients at risk
Studies have shown that the high cost of prescription drugs has put patients at risk.

The nonprofit research group, Center for Studying Health System Change, said last month that more than 18 percent of U.S. adults did not fill at least one of their prescriptions in 2003 because of the cost.

The center’s president, Paul Ginsburg, said pill-splitting was unorthodox but effective in increasing access to care.

“It may be the difference between being able to take the drug and not being able to,” he said.

For factory worker Schneider, splitting his pills at the suggestion of his pharmacist is not a life-or-death decision, since his cholesterol is back to normal. But for a father of three with a mortgage on a new house, every penny counts.

“Most people, it probably doesn’t faze them to just go ahead and pay for it, but I’ll take whatever route is necessary to keep costs down,” he said.

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