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Inexpensive drugs: reduction money by splitting pills - medicine


One of the least esteemed cost-savers in health care is the clean act of splitting pills. Consider you're a U. S. inhabitant with depression who needs to take Lexapro brand of escitalopram oxalate, a frequently prescribed antidepressant, at a classic opening dose of 10 milligrams (mg) per day. Let's appear out how much your conduct will cost, both by month and by day.

For purposes of illustration I'll use prices shown online at drugstore. com. If you buy thirty Lexapro 10-mg pills (which is how the prescription is customarily written) it will cost you $70. 15 per month or $2. 34 per day to get treated. But what if you buy Lexapro 20-mg pills and take a half-pill each day? Medically, this behavior is the same. But look what happens to unit prices. Thirty Lexapro 20-mg pills cost $69. 99. We need just 10 mg per day, so we split the 20-mg medicine in half to make our 10-mg doses. (The medication are even scored to make this easy. ) In this case it costs you just $35. 00 per month or $1. 17 per day to get treated. Your daily price just dropped by half!

Isn't that amazing? And it's not just an cut off example. If you do a analogous assay for many other drugs, you'll find that charming half of a double-strength pill costs substantially less than attractive all of a regular-strength pill. Or an added way of aphorism this is that the cost of a month's conduct is obsessed more by the digit of pills complicated than by the total come to of milligrams taken.

Is this an calamity of pricing? Must we be whispering about this? Is this pulling a little over on the drug companies? Hardly. If you think that multi-billion-dollar companies trading on the New York Stock Argument make pricing mistakes, then I've got some abundance swamp-land in Florida I'd love to sell you.

So why would drug companies coin these pricing mismatches (read: opportunities)? To be au fait with this, let's walk by means of two prescribing scenarios. First, consider a medical doctor is prescribing Lexapro to a long-suffering who is lucky an adequate amount to have drug insurance. The long-suffering pays a determined co-payment for each month's worth of medication, so he or she has the exact same out-of-pocket deprivation whichever way the prescription is written. So will the medical doctor write for thirty 10-mg pills or fifteen 20-mg pills?

Your guess is almost certainly right-the prescription will be printed for the better come to of lower-strength pills. The dealer and the drug band will get full price. They're happy. The enduring doesn't need to break drug in half and the general practitioner doesn't need to take time to defend why pills have to be broken, so they're happy. What's not to like? The only loser is the assurance company. Do the medical doctor or the tolerant care? (Let's see, how many special treatment has the cover business done for the medical doctor and enduring lately?)

Now here's the be with prescribing scenario. Joe Workingman has no drug cover and has to shell out cash to pay for the full price of medication. The general practitioner feels that 10 mg daily of Lexapro is needed. This time, the physician prescribes fifteen Lexapro 20-mg pills per month, instructing the long-suffering to take a half-pill per day. Medically, there is no loss of efficacy. The long-suffering is happy to pay less money. The physician is a hero for being brooding and clever. Since the general practitioner still prescribed the same product, the drug business is happy. (The drug ballet company would fairly get half their price than nothing. Besides, they've before now priced this scenario into their drug. )

So the drug band wins also way, chiefly if they're competing aligned with a akin consequence made by a different ballet company that the medical doctor might decide instead. In fact, all it takes for all and sundry to be happy is a fragile tablet. Admittedly, some pills are challenging to break in half (but not excessively difficult, or else the drug business wouldn't capture the low-end market). This is where pill-cutters come in handy. Every drugstore has them. They're cheap since they're made out of nil more than artificial and razor blades. They're beat at splitting pills than your thumbs or a paring-knife as they break pills more evenly, and the pieces don't go skittering crossways the counter.

In the author's attempt there are some pill-splitting overachievers who even deal with to break quadruple-strength pills into quarters. Dream up the savings in doing that.

In fact, the only difficulty to reduction the long-suffering money is if the drug business puts their effect into capsules, for the reason that capsules can't be split. Would a drug circle do such a mean-spirited thing? You betcha.

Lexapro was the sixth so-called serotonin-reuptake-blocker to come on the market, so it had to compete with all the beforehand drugs in its class. But the first serotonin-reuptake-blocker to come on the advertise had first-mover gain and was able to hold on to market-share even after the competing crop arrived. This first-mover was the world-famous Prozac brand of fluoxetine, made by the Eli Lilly Company.

So what did Lilly do after competing foodstuffs appeared? They stone-walled the consumer by never ever putting their artifact into everything other than a capsule. Moreover, for the total time their consequence was still patent-protected, they never bent a higher-strength capsule. So if you desired a senior dose of Prozac, you had the honor of paying for two or three capsules per day. Why did they decide such a consumer-unfriendly approach? As they could. (Everyone now turn for Indianapolis and wave to the nice citizens at Lilly. )

My checkup students look at me strangely when I start discussion about freely traded companies and promote air force while I'm aimed to be credo them about medicine. But the way I look at it, if you don't appreciate marketplace forces, then you'll never appreciate why belongings in medicine are the way they are.

(C) 2005 by Gary Cordingley

Gary Cordingley, MD, PhD, is a clinical neurologist, educator and researcher who works in Athens, Ohio. For more health-related articles see his website at: http://www. cordingleyneurology. com


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