Many years ago, I had read about the idea of pill-splitting to save money. For many medications that come as tablets or pills, it's possible to split them in half (either with a knife or a specialized pill-splitting device) and take a half-dose at a time. The cost saving is based on several assumptions:
Why bother? It's because of the way pills are priced: frequently, medications which are available in "double" strengths are comparably priced to their lower-strength sibling, being only slightly higher per pill. So, if the medication that I describe above costs $.95 per pill for the 25 mg size, then 100 pills would cost $95.00 and would last 100 days. But if the 50mg size costs $1.00 per pill, and the pills are split, then 100 days' supply would require only 50 pills, and cost the patient only $50.00!
Medco's website lists several criteria that should be considered by you and your physician when thinking about splitting pills. Unfortunately, the list cannot be accessed through Google. Here's a modified version of their criteria:
One discussion I found on line (Which medications can be split without compromising efficacy and safety?) points out that "recommending tablet-splitting to insured patients solely to spare them copay - instructing a patient to take a half tablet to make a 30-day paid prescription cover 60 days - may be considered insurance fraud. However, this is not an issue for patients without prescription coverage."
At least one big insurance company, United Healthcare, actually encourages the practice, and has set up a website about splitting tablets and gives away a tablet splitter: http://www.halftablet.com. Although nominally for UHC patients, this website has helpful information for everyone, including a listing of medications that UHC has found to be splittable, and a list of references supporting the concept of splitting (see the FAQ page).
And another article (from a law firm!) points out some of the concerns about pill-splitting, in an article called Cutting Corners. This article indicates that one HMO (Kaiser) has routinely encouraged pill-splitting.
Should you start splitting pills? If you are on a tablet that can be safely split in half, and are comfortable with the idea, and want to save money, talk to your physician. Ask if he/she will write a prescription for a double-sized strength of your medication so you can start splitting your pills.