Cutting Tablet Prescription programs

[CEB]

I wanted to find out if any of you have adopted a cutting or splitting RX tablet program for employees?

A little background: The idea behind this program is that an employee gets a 15 day supply of 40mg and they split it in half to have a 20mg tablet for 30 days (the member doctor is basically prescribing the 20mg strengh for 30 days). This I believe saves the employer money and in some cases if this program is adopted by the PBM, than the member has a set list of drugs they can split (example a time release drug would not be listed because it may not be safe) and the employee pays only 1/2 of their normal copayment. We are looking at some brochures and are thinking about adding it to our current RX benefits. Please let me know how you think this should be marketed to the employees and how to enourage them to participate (for drugs that can safely be split). Thanks!

[Guest bobolink]

There's a good article on this practice in the July Employee Benefits News and EmployeeBenefitsNews.com

[GBurns]

If the Dr prescribes 20mg x 30, How is the person going to get 40mg tablets ? I doubt that there are any Pharmacists who would change the specifics of the prescription.

Also, splitting a tablet is not advised. The manufacturers have stated that there is no guarantee that the active ingrdients are evenly distributed throughout any tablet or capsule. Would you be willing to accept the liability for the patient not receiving the required dosage because you mandated splitting and which splitting caused the medicatioon not to work ?

[GBurns]

The article mentioned by bobolink is at www.benefitnews.com

http://ebn.benefitnews.com/ebn_issues/3_10/

http://ebn.benefitnews.com/ebn_issues/3_10/

[Guest Robin.Wolf]

This type of program assumes that the patient's physician will write a prescription for a dose which s/he knows to be in excess of what is appropriate, relying on the patient to split the tablets correctly and consistently. If I were a treating physician I would feel that I was assuming all the risk and obtaining no benefit. Malpractice claim, anyone?