[o11c]

Let's suppose arithmetic is a solved problem and only consider manufacturing and distribution.

The major barrier to self-managed dosing, even if you want to do it properly, is that there's a huge difference between one pill and two pills. And trying to cut pills in half (if even possible for a particular pill structure) often makes very uneven halves (which is a problem for day-to-day variation even if a consistent "10% more than half" dose would be fine).

I have seen dose differences of ~10% to be ignored between brands or over time, so that's probably safe-ish to ignore (certainly much better than the current 50%-if-lucky-else-100%). But counting out 10 pills is certainly a pain; realistically, aiming for a 5-pill typical dose would be more reasonable.

My impression from looking at OTC costs is that the bottle costs more than anything, so manufacturing probably isn't the bottleneck. A side-effect of the current "one pill" mindset, in conjunction with expiration dates, is that low-dose pills are generally not available in higher counts, but there's nothing fundamental about this.

Are there any "delayed/gradual release" concerns that get worse for many small pills rather than one large one? If so, is it really more significant than the wrong-dose problem?