Practice Management Tip #2: Cutting Medications Saves Money

Some medications such as Lipitor and Crestor are very effective but expensive. To help patients save money, I often have them cut their tablets in ½. The reason why this technique saves money is because different strengths of a medication are typically priced the same. Therefore, by cutting the tablet in half, patients are getting twice the amount of medications for the same price. But there is a caveat to this tip. If you write your script like this:

      Lipitor 20 mg
      Take ½ tablet by mouth 1x/day
      #30

Guess what! The pharmacy will only give the patient #15 tablets instead of #30 for a month. And that will really annoy your patients! Not only do they have to pay the same price for their Lipitor, but now they also have to cut all their tablets in half! To get around this ridiculous problem, here's how I write my scripts:

      Lipitor 20 mg
      Take 1 tablet by mouth per day or as directed by your physician
      #30

My patient and I have an understanding that the phrase "or as directed by your physician" is our secret code for "cut the tablet in half". This obviously requires that 1) you have excellent communication with your patients and 2) you have a good way of documenting the correct dose in your chart. Also, be prepared to get irritating faxes from the insurance company stating that your patient has not been compliant with their medication. These notifications I promptly place in the shredder.

Obviously, not all medications are amenable to this tip (i.e. capsules, tablets with special time-release coatings, or tablets that are oddly shaped). However, that still leaves quite a few medications that can take advantage of this tip.