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.
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