Changes

Thus, a patient who needs a 20-mg dose can obtain 180 doses either by buying 180 20-mg tablets for $139.95<ref>2 &times; $73.97 = $147.94, but we are using $139.95 because this is the pharmacy's actual quotation for 180 tablets</ref>, or by buying 90 40-mg tablets for $74.97 and splitting them, a very significant savings.

Thus, a patient who needs a 20-mg dose can obtain 180 doses either by buying 180 20-mg tablets for $139.95<ref>2 &times; $73.97 = $147.94, but we are using $139.95 because this is the pharmacy's actual quotation for 180 tablets</ref>, or by buying 90 40-mg tablets for $74.97 and splitting them, a very significant savings.

This pricing pattern occurs for several reasons. First, drug companies say that they charge almost the same price regardless of dose as an ethical matter, and to avoid creating any financial incentives for choosing anything less than the proper dosage. Second, the marginal cost of the drug in the pill is usually very small compared to the price of the pill. And, third, prescription drugs are a very inefficient market in which pharmaceutical manufacturers have the power to set prices (as opposed to having prices driven down to something close to their actual costs).

This pricing pattern occurs for several reasons. First, drug companies say that they charge almost the same price regardless of dose as an ethical matter, to avoid creating any financial incentives for using anything less than the proper dosage. Second, the marginal cost of the drug in the pill is usually very small compared to the price of the pill. And, third, prescription drugs are a very inefficient market in which pharmaceutical manufacturers have the power to set prices (as opposed to having prices driven down to something close to their actual costs).

The practice is controversial. Drug manufacturers oppose it, partly for self-serving reasons, but partly out of serious concerns. Not all pills are designed to be split, and the production process is not necessarily designed to distribute the drug evenly within the pill; thus, even if the pill splits into two portions that appear equal in size, they may not contain equal quantities of the drug. Generally speaking, if the pill is not manufactured with a scored groove, it is not intended to be split.  

The practice is controversial. Drug manufacturers oppose it, partly for self-serving reasons, but partly out of serious concerns. Not all pills are designed to be split, and the production process is not necessarily designed to distribute the drug evenly within the pill; thus, even if the pill splits into two portions that appear equal in size, they may not contain equal quantities of the drug. Generally speaking, if the pill is not manufactured with a scored groove, it is not intended to be split.