A drug is available in 8 mg and 16 mg sizes, and the 16 is scored for cutting in half. The price for 90 day supply for the 8mg is $154.84 and for the 16mg is $154.97, or only $.13 more.

If you need to take 8mg daily, and order the 16mg and cut them in half, you effectively cut your costs in half.

Is this "insurance fraud", as a pharmacist has told me, assuming the prescription says "16 mg, take 1/2 pill daily".

Hello d:

No, it's not insurance fraud. It's not even against the law. Buy what you want and cut it into 15 pieces if you want. Tell the pharmacist to stick with mixing drugs.

excon

He is supposed to give you 45 each 16mg pills or 90 each 8mg pills. (720 mg in 90 days)
If they are giving you 90 16 mg pills, they are not following the prescription.
But if there is any fraud, the pharmacist is committing it.
I have been getting a prescription for 1/2 a pill for many years. For a 90 day supply, they give me 45 pills. The prescription is x mg per day, not the number of pills.

The pharmacy has a way to prevent that sort of stuff. Some have a rule that if you don't order within 6 months, you have to start with a 30 day supply again. Initial fills must be for a 30 day supply. Unfortunately, you are paying for a 90 day supply of the medication. They can easily pick that up and might confront you for maintenance medications.

The cutting works for plans that pay a % of the meication cost.

I take 1000 mg 2x/day of a medication, but I have it prescribed as two 500 mg tablets 2x/day for the reason that they are easier to swallow. In this case, it's kind of reverse. It's probably more expensive to supply the 500 mg rather than the 1000 mg. The employer's cost of the plan based on the acual cost for the supplier of the plan.

Other drugs such as Viagra have limits like 6 per month and 25/50/100 mg tablets are about the same in price and would be the same in price for a 90 day supply. They are not scored, but can be cut. So if you only needed 25 mg and got 100 mg and prescribed at the limit. "Take one PO before sexual activity". Fraud. Maybe, Ae you going to get caught - doubt it.

PRN medications are just as weird. Might get a 15 day supply with 3 refills.
Hw often I use it depends on the weather.

So you have a medication that gets 200 inhalations PRN. That's 100 uses. Can be used every 4 hours, so that's a 100/8 days supply. It could easly last a year, because I'm not supposed to use it unless I have to.