Have you ever considered splitting your prescription medications to make them last longer? Many people are looking for ways to control their health care costs, especially since the Kaiser Family Foundation estimates that spending on prescription drugs in the United States rises more than 10 percent a year. Pill splitting is now being recognized as a legitimate way for patients to get the medications they need while saving money. This practice helped the Veterans Administration save almost $50 million in 2003 on prescription drugs. But it is not for everyone or every medication and patients need to know a few basics before they even consider pill splitting as an option. Pill splitting works because drugmakers make a handful of popular medicines available in a choice of strengths for the same price. Currently, 16 medications have been approved for splitting, including Lipitor (used to lower cholesterol), Zoloft (an antidepressant) and Valtrex (an anti-viral). With a doctor's OK, a patient can order his or her medication at twice the needed strength and cut each pill in half. The patient receives half as many pills in each refill but pays half the usual co-payment, for a savings of 50 percent. For example, Lipitor is priced the same in 20-milligram and 40-milligram dosages. A patient may purchase a 40-milligram tablet and then split the medication for his or her daily dosage amount. Drugmakers argue that there could be health risks for people who split pills incorrectly or attempt it with inappropriate drugs. Further, pill splitting is not advised for people who suffer from dementia, severe arthritis or poor vision. In addition, pill splitting may not be a good option for people who take several medications. "Patients should always talk to their physician before making any change to their care regimen," said Dr. Lewis Sandy, UnitedHealthcare's executive vice president of clinical strategies and policy. "Pill splitting can be a useful tool to save money, especially if you have to take a prescription drug for a long time. But not all pills can be safely split, and this practice is not appropriate for everyone." One company, UnitedHealthcare, recently launched the second phase of its Half Tablet Program, which offers free pill splitters to members taking medications approved for splitting. The program requires physician approval for enrollment. The following steps should always be followed when considering pill splitting: 1. Consult your physician when considering any changes to your health care. Pill splitting can only be done with your doctor's approval. 2. Make sure your physician knows about all medications you are taking, including vitamins and herbal supplements. It is important for the doctor to know your entire medical history before making recommendations on your prescription drugs. 3. Review the approved list of medications for pill splitting with your doctor to ensure that your medication is included. 4. Always use a pill splitter to cut medications in half and make sure the medication fits securely in the device. Never attempt to cut a pill with a knife, scissors or anything else. 5. Tell your doctor about any changes in your health status that may make it difficult for you to split your medications. He or she may decide with you that returning to whole pills is the best option.