Pill Splitting: When Is It Safe? When Is It Unsafe?

Want to save almost 50% on some of your prescription drugs? Buy a $5 pill splitter.

Well, it's not quite that simple. But because of a quirk of how some drugs are priced, a tablet that's twice as strong as another may not be twice the price. In fact, it might be about the same price. So, sometimes, cutting a higher strength pill in half can get you two doses for about the price of one. With a little manual labor -- just snapping down the lid of a pill cutter with your finger -- pill splitting can save quite a lot of money.

Pill splitting is a cost-saving solution so effective and so simple that many people -- not to mention health care systems and HMOs -- have embraced it.

But pill splitting is not right for every person, or every pill. "Sometimes, it makes a lot of financial sense to split pills," says Kevin Schulman, MD, Professor of Medicine and business administration at the Duke University Medical Center in Durham, N.C. "But if you try to split the wrong sort of medications, that could be potentially dangerous."

So here's the lowdown: when pill splitting makes sense and when it doesn't.

Why Cutting Pills Cuts Costs

First, you might want an answer to the obvious question: how could this be? Why would a drug that's twice as powerful as another cost the same? It's a marketing strategy sometimes used by pharmaceutical companies called "flat pricing." Regardless of potency, the price of a specific pill is more or less equal.

Part of the reasoning is that it protects patients from price jumps if they start to need a higher dose of a medicine. Suddenly doubling the price of a drug they've been using for years might cause them to stop taking it. It also might be seen as financially punishing a person for getting sicker, says Schulman.

It also has to do with production expenses. The cost difference in manufacturing a 10-milligram pill and a 20-milligram pill is less than you might think.

"With some drugs, the biggest cost is not the active ingredient, but making the pill itself," says Rich Sagall, president and co-founder of NeedyMeds, a Philadelphia nonprofit that provides information about financial assistance for drugs. "And that cost is pretty much the same no matter how much of the active ingredient is used."

While it was probably not the intention of pharmaceutical companies when they devised this pricing system, it's ideal for the practice of pill splitting.

Pill Splitting: Which Drugs Can Be Split?

If you're interested in pill splitting, the first step is to talk to your doctor or pharmacist. Find out if any of the medicines you use can be safely split. Equally important, find out whether splitting them will save you enough money to justify the slight inconvenience.