Changes

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 almost at will.

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 almost at will.

The practice is controversial. Drug manufacturers oppose it, partly for self-serving reasons, but partly out of serious concerns.  It is dangerous when a pill is not designed for splitting, or if it is a drug in which it is important for every dose to be precise. Even when a pill is intended for splitting, splitting reasonably good eyesight and coordination, and it is one more instruction that a patient needs to follow correctly. Thus there is an increased danger of the patient making dosage mistakes.

The practice is controversial. Drug manufacturers oppose it, partly for self-serving reasons, but partly out of serious concerns.  It is dangerous when a pill is not designed for splitting, or if it is a drug in which it is important for every dose to be precise. Even when a pill is intended for splitting, splitting requires reasonably good eyesight and coordination. It is also another instruction that a patient needs to follow correctly. Thus there is an increased danger of the patient making dosage mistakes.

Nevertheless, some insurers and large organizations are actively encouraging the practice of buying tablets with twice the appropriate dose and splitting pills. For example, Illinois recently began encouraging Medicaid patients to do this with some drugs<ref>[http://web.lmic.state.mn.us/issues/scan.htm?Id=3168 Illinois asks Medicaid patients to split tablets to save money], while the University of Michigan supplies free pill-splitting devices and encourages students and faculty to take advantage of the practice as a way of saving on co-payments.<ref>[http://www.umich.edu/~urecord/0506/Jan23_06/02.shtml Pill-splitting program to cut cost of employee co-pays], University of Michigan Record online</ref>

Nevertheless, some insurers and large organizations are actively encouraging the practice of buying tablets with twice the appropriate dose and splitting pills. For example, Illinois recently began encouraging Medicaid patients to do this with some drugs<ref>[http://web.lmic.state.mn.us/issues/scan.htm?Id=3168 Illinois asks Medicaid patients to split tablets to save money], while the University of Michigan supplies free pill-splitting devices and encourages students and faculty to take advantage of the practice as a way of saving on co-payments.<ref>[http://www.umich.edu/~urecord/0506/Jan23_06/02.shtml Pill-splitting program to cut cost of employee co-pays], University of Michigan Record online</ref>