Tuesday, December 8, 2009

Who Likes Free Drug Samples?


Most doctors have a closet in their office filled with various pharmaceutical samples. The pharmaceutical industry has had "drug reps" or account reps or pharmaceutical sales staff making the rounds on doctors offices in every city and town across the United States for decades. The industry spent $33.5 billion promoting drugs and sending reps to doctors offices with samples in 2004. That is a lot of samples!

Most of us thought we were doing the right thing for our patients when we accepted drug samples. I was able to give patients a month (or more) free to make sure it worked and that they tolerated it. Other patients had no insurance and I supplied them with all of their medication for free from my sample closet. I had a good relationship with the rep and they kept my office stocked with the medication my patients needed. It seemed like a win-win for everyone.

But new information is coming out that makes me take pause. A 2008 study published in Medical Care said that patients who got samples paid $66 more over six months than patients who did not get free samples. Are physicians influenced to prescribe high cost, brand name drugs rather than cheaper generics? With Americans spending $200 billion in prescription drugs in 2002, it serves the pharmaceutical giants well to give out samples and potentially influence those choices.

When physicians are interviewed, they all say the samples, free pens and sales pitch does not influence their prescribing habits. No one likes to think they are influenced when they accept samples and when queried, they say they are choosing the best drug for the patient.

The bans on accepting samples are coming from hospitals and academic institutions, not from physicians who are actually seeing patients day in and day out in their offices. The AMA and the American Academy of Family Physicians say it is OK for physicians to dispense free samples. But more and more academic institutions along with Kaiser Health Plans are banning sales reps completely.

Everybody likes something for free. We just need to make sure it isn't free today...more costly tomorrow.

17 comments:

Anonymous said...

I have always liked getting samples from the doctor. Sometimes even the copay is too much if you have a reaction to a drug and have to stop taking it. My doctor has never pushed any drug on me and getting the sample really helps.

KM said...

With the economy being so bad as far as job losses and people losing their insurance I know a person who is being really helped with the samples who has an extremely high cost of $624 a month cobra which is extremely difficult for her to afford after a job loss.

mitchsmom said...

http://www.nofreelunch.org/aboutus.htm

From what I have read, the studies show the providers are more influenced by the samples than they consciously realize.

I think it's unethical marketing practices, the companies know what they're doing... they wouldn't do it if they weren't getting more profits from it in the long run. It all drives up prices of the final product - it's the same thing with infant formula.

Raymond Bouchayer said...

Yes it is very nice to get samples from your Doctor . The drug industry has been and is overcharging the American public for the same medicine that can be had for 10c on the dollar in some other country .....manufactured by the same pharmaceutical , do not get "brainwashed " that only here we make good drugs ...its nonsense,complete , absolute nonsense , but then look at our new "health plan " that our politicians are getting paid to shove down our throat to profit the pharmaceutical and Insurance companies .. Yes Doctor a free sample is always welcome ,our way of "getting even".

Raymond Bouchayer said...
This comment has been removed by the author.
Michael Kirsch, M.D. said...

Wouldn’t want to be a drug rep now. One by one, their tools of the trade are being eliminated. They’ve lost the pens, pads and post-it notes. No more dinnertime seminars where docs could serve as ‘consultants’ and leave the restaurant with a cash honorarium. Remember ‘dine & dash’? Lunches in physicians’ offices are disappearing, demoralizing nurses and secretaries throughout the country. And now, free samples are on the chopping block. Will physicians still give these pharm reps the time of day?

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Cary said...

One of my doctors had a Zoloft clock on the wall. I really wanted to steal it and put it up in my office. What time is it? Time for another Zoloft!

I hope they don't stop giving out samples. I like them. But yes, doctors are surely influenced by them.

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Cindy Gobillot said...

So I take it you still give out samples...very helpful to your patients, if used wisely - perhaps to those who need a trial to see if the medication will work... perhaps to a patient who is in financial straits.
But I'm wondering - how do you keep track of your sample closet?Do you know when the drugs are expired or recalled? How often to you run out? Do you know who gets which samples? Is your staff taking anything without your permission? What's the liability issue here?

Toni Brayer, MD said...

Cary: My husband has a viagra tie. I think it will be a collectors items for sure.

Cindy Gobillot: Yes, keeping the sample closet updated and inventoried is a huge deal. Most doctors are not very systematic about it and samples can easily walk. We always kept controlled drugs locked with good inventory monitoring. There can always be liability issues but I am not aware of any lawsuits around "samples". Don't tell the attorneys or it will surely be next.

Sam said...

drug samples are very helpful if used properly--allows experimentation with dosage and product. Generic drugs have a purpose as well and should be considered even first. I would not use a doctor that does not see a drug rep because these doctors tend to fall behind on latest treatment options. FP and MI doctors are too busy working to keep up with all the changes. sample meds can be a win win for all and especially for the patient. There is great software out there to track sample medications as well. Finally like any industry if you take the capital incentive away from drug companies to come up with new ideas the USA will end up like other countries such as Canada. Nothing new in the drug realm is invented in Canada because opportunity has been stifled by price control. Wait and see. former rep for many years and self employed in many ventures for most of my life. Sam

Cindy Gobillot said...

Sam - you said that there is great software out there to manage samples...any links or recommendations?

Jeff said...

Hi Sam.
Scanning through the post, I took note of your assertion that there is software out there for pharma sample inventory control? I'm in CT and the legislature is looking to pass new laws about samples and tracking inventory. Wondering if you could provide a link? Is this a paid service? thanks.

Sam said...

Jeff and Cindy, sorry I took so long to respond back--I just happened back to this blog. I actually own a software company that has developed an easy drug tracking system. The program tracks lot numbers, expiration dates to patients and provides inventory features with the ability to track patients in the event of a recall. After years of seeing sample drugs closets treated like a candy store and expired retail clinic meds that go to waste-- something needed to be done. We recently passed a Joint Commission review at one of our clinics. TraxaMED is the name of my product owned by Sample Tactics, LLC. Please feel free to email me if you would like a demo. Thanks,
Sam speila@sampletactics.com

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