A recent mailing from my employer's department of reducing health-insurance
costs (that's probably not their real name) offered some advice that
seemed questionable to me. They suggested splitting pills -- not, they
hastened to point out, that we should take half the dosage we need, but
rather, we should get pills that are twice as strong as they need to be
and then split them. They suggested that a stronger drug doesn't
necessarily cost any (or much) more to fill, so you can fill your
prescription half as often, saving you half the copay and them a lot on
the balance. (Aside: what bright person decided that your cost, if
insured, should be per month rather than per some volume?
If I take a medicine twice as often as you do, why shouldn't I pay twice
as much for it?)
I wonder how the pill-splitting scheme could actually be implemented legally
and what doctor or pharmacist would go along with it. I find it hard to
believe that a large company would advise its employees to commit insurance
fraud (in a manner that's traceable), so there must be a way to do it, but
I'm puzzled. (The company self-insures; maybe that's why it's ok?)
I was telling this to Dani last night, and commented that even if it's
kosher I can't benefit from it for my prescriptions -- the medicine
I take for glaucoma is in the form of eyedrops, and I don't know how to get
double-sized drops. (Nor am I going to ask my ophthamologist to write a
bogus prescription.) This, combined with some recent TV viewing, led us to
wonder how big a drop is, anyway. We didn't have an internet connection
to hand; Dani tried to work it out theoretically while I tried to
work it out empirically. (Things often fall out that way with us.) A
medicine that I take once a day (two drops) comes in a 2.5ml bottle and
lasts about a month (maybe a little more). Viscosity matters, of course;
this stuff is closer to water than to syrup. So I posited about 25 drops/ml
for my medicine. (Google later suggested 20 drops/ml of water as an
approximation.)
And that's when we turned our attention to the amount by which a character
in the True Blood episode we'd just watched overdosed. The character
had a quarter-ounce vial of an illegal substance (vampire blood) that he was
supposed to take one drop of at a time. Wikipedia tells me that the
viscosity of normal blood is about three times that of water. It has
no data on vampire blood. Assuming (and I don't know if that's valid)
that drop size is directly correlated with viscosity, this suggests that
the character overdosed by a factor of approximately 46. Ouch. :-) (Yes,
it did hurt.)
Ok, fine -- what have you done with your science education
lately? :-)