Statins: Cost Effectiveness of Splitting Doses

• In the United States, some major drug plan insurers have implemented tablet-splitting programs that target statins.
• Tablet splitting has been shown to reduce prescription costs substantially without negatively affecting laboratory outcomes or compliance
• In addition, patients have found tablet splitting to be simple and acceptable

Supporting Evidence

• A retrospective chart review of total cholesterol and LDL cholesterol values of patients instructed to split simvastatin or atorvastatin between January 1999 and November 2000
• The overall results for this review demonstrated no statistically significant increase in total cholesterol and LDL cholesterol concentrations. Total cholesterol and LDL cholesterol values actually decreased from presplitting to postsplitting, p = 0.017 and p = 0.003, respectively.

Manufacturers Recommendations

• No information provided on tablet splitting
• Most drug companies oppose pill-splitting. They say it can be dangerous. But studies to date have not shown any adverse impact on health on the drugs listed safe to be split

Not To be Split

• combination medications such as Liptruzet (atorvastatin/ezetimibe), Advicor (lovastatin/niacin) or Vytorin (simvastatin/ezetimibe)
• time-release drugs, such as Altoprev (lovastatin sustained-release tablets), or Lescol XL (fluvastatin sustained-release tablets)

Ways to Split

• don’t use a knife—studies show doing so can result in unequal halves. Instead, get a pill splitter device.
• A good practice is to split your pills one at a time, and take the second half as your next dose

References:

1. https://www.consumerreports.org/cro/news/2014/03/is-it-safe-to-split-my-statin-cholesterol-drug-to-save-money/index.htm
2. https://www.ncbi.nlm.nih.gov/pubmed/11847935
3. Dormuth CR, Schneeweiss S, Brookhart AM, Carney G, Bassett K, Adams S, Wright JM. Open Med 2008;2(3):5–13
4. January 1, 2006 University of Michigan Prescription Drug Plan