Cost-Savings From an Antipsychotic Tablet-Splitting Program.

BACKGROUND: Newer atypical antipsychotics such as aripiprazole (Abilify, Otsuka) and lurasidone (Latuda, Sunovion) have favorable safety and efficacy profiles, but their use is limited by high cost. University Hospitals Richmond Medical Center initiated an antipsychotic tablet-splitting program in August 2015 to counter the costs based on the identical pricing structure of aripiprazole and lurasidone doses. METHODS: A retrospective chart review was completed for all patients dispensed aripiprazole or lurasidone oral tablets from May 1, 2015, through December 31, 2015, to evaluate the potential cost-savings for our facility. Findings were extrapolated to 12 months to estimate an annual cost-savings from tablet splitting. RESULTS: Two-hundred thirty-five charts were reviewed during this eight-month period. Estimated annual savings ranged from $3,617 for lurasidone 20-mg tablets to $6,637 for aripiprazole 5-mg tablets. The antipsychotic tablet-splitting program for lurasidone and aripiprazole resulted in 30% to 50% annual savings for each individual medication strength. Previous literature suggests variable percentage of weight deviation in tablet-splitting studies; however, small deviations in weight may not be clinically relevant for antipsychotic agents based on their mechanism of action. CONCLUSIONS: Aripiprazole and lurasidone are optimal agents for tablet splitting. Initiation of a tablet-splitting program has the potential to save up to 50% of drug costs for an inpatient hospital. Splitting of aripiprazole and lurasidone tablets may decrease drug cost and waste while ensuring patient accessibility to treatment.