A practice that's been used for decades to save patients money - pill-splitting - is drawing new interest as more people seek ways to cut healthcare costs.

Doctors have long counseled patients with costly chronic illnesses to cut their costs by literally splitting their pills – getting them at a double strength dose and then cutting them in half. It's possible, in large part, because pharmaceutical companies use a practice known as flat pricing, which makes the cost of a prescription drug at different dosages almost identical. This practice stems from relatively equal production costs and a desire to retain the patient as a customer by keeping pricing stable even if a change in their medical condition results in the need for a higher strength tablet.

According to Drugs.com, many common medicines that are taken on a daily, long-term basis can safely be split, including Crestor, Lipitor, Cozaar, Diovan, Lexapro and Zoloft. Before adopting this measure, however, patients need to be aware of important safety considerations and some precautions.

The first thing a patient considering pill splitting needs to do is discuss this with their doctor and/or pharmacist to find out if the medication can be split safely and whether doing so will actually save money.

Patients are usually advised that the only pills which can be safely split are those in which the manufacturer has placed a scored line down the middle.

Pill splitting should not be done with household tools like knives and scissors. Most drug stores carry a variety of pill cutters, which provide the most accurate splitting method. Cutters retail for about five dollars and typically have a means of holding the tablet in place, a blade and a compartment in which to store the unused part. The tablet is put into position within the cutter and the blade is pressed down to split it.

The process itself should be done one pill at a time, instead of a whole bottle at a time, as exposing ingredients to air through the cutting process can affect their potency.

Pill splitting is not an option for all medications. Many can’t be split safely because of their structure or the nature of their ingredients.

The following should NOT be split:
• Birth control pills
• Chemotherapy pills
• Blood thinners
• Anti-seizure medications
• Pills that easily crumble into many pieces
• Drugs in capsules
• Time-release or long-acting drugs
• Pills with a coating to protect the stomach
• Drugs taken more often than once a day
• Pills with ingredients that can harm your teeth and mouth

Patients considering pill-splitting need to be cognizant whether they are taking drugs that can be safely split while delivering the same efficacy needed to treat their medical condition or not. It is important to discuss the specific pills being considered for splitting with a physician or pharmacist to ensure doing so will cause no harm.

Resources for more information on reducing prescription costs:

http://www.drugs.com/news/most-americans-would-consider-splitting-pills-save-money-if-medicine-remains-safe-effective-survey-17821.html

http://www.upmc.com/healthatoz/pages/healthlibrary.aspx?chunkiid=28256

http://www.healthkey.com/health/drugs-medicines/prescription-drugs/hw-te7832-1,0,613125.story

http://www.science20.com/news/making_cholesterol_treatment_cheaper_cut_pills_in_half