Rich_in_Tampa said:
Hey RichinTampa,
my dad is on Lipitor 10mg daily. He lost his insurance and had to pay cash for a while
and I helped him since I'm in the business. The prices are the same for all strengths. So the first month I split 20mg tabs in half; 2nd month 40mg in quarters; 3rd month I cut 80mg tablets in eighths. I didn't think it could be done but was accomplished with moderate ease and success. So I was able to buy him #4 80mg tablets that magically turned into 32 slivers for a monthly cost of about $12.
Granted his daily dose was probably between 8 to 12mg, but not critical with this
med IMHO.
Pill cutting can be a very cost-effective strategy. Most pills that are not "time-release" or XL, or CR, or ER can be split but not all. As you say, check with the pharmacist carefully on each drug. Importantly, the designer version may be replaceable by the mundane version (lovastatin versus atorvastatin - lipitor) but in some cases it matters. For example, lipitor raises HDL a bit more than lovastatin, etc. But I am always happy to advise my patients on when it is wise and when it isn't (cutting, swapping, etc.).
With drugs like hydrochlorothiazide, doses of 12.5 mg (below the standard tablet size of 25mg) are often just as good for most patients. And convenience pills which combine two common other drugs are often more expensive than the combination bought separately. Then there are drugs which are completely equivalent but vary drastically in price (e.g. medrol and prednisone) with appropriate dosing. Too much for a layman to track but a few words about cost consciousness to a friendly primary care doctor should do the trick.
I still use lots of good old generic stand-bys. Until the evidenc shows the newer fancy product is clearly better I figure "if it ain't broke, don't fix it."