Drug samples are a staple of pharma- ceutical marketing. The drug industry argues, quite logically, that samples are useful to treat patients who lack the funds to purchase medications. Yet some reformers have called for drug samples to be banned, an idea that has received a decidedly mixed reception. A small body of research has investigated the topic of drug samples, including a recent study that examined changes in prescriptions when samples of brand- name statins, levothyroxine, and SSRIs were removed from an internal medicine clinic in Iowa. Over the 180-day period in which samples were removed, generic prescriptions increased by 23% for statins, 10% for SSRIs, and 3% for levothyroxine (Miesner AR et al., Arch Intern Med 2009;169:1241-1242). In another study, a university-based internal medicine clinic moved, leaving its sample closet inaccessible for nine months. During this time, the rate of generic pre- scribing for uninsured patients increased from 12% to 30%, though there was no change in generic prescribing for Medicaid patients (Miller DP et al., South Med J 2008;101:888-893).
Surprisingly, drug samples are more often given to insured Americans than to the uninsured or poor (Cutrona SL et al., Am J Public Health 2008;98:284-289). In that case, drug samples also tend to increase costs for patients who receive them (Alexander GC et al., Med Care; 46:394-402); when patients receive a sample, they often remain on that more expensive drug once the sample expires rather than switching to a less expensive generic drug. Samples probably produce overall cost savings only if they will be given indefinitely to patients who have no coverage for prescriptions and cannot afford to pay out of pocket for generic drugs.
TCPR’s Take: The combined results of these studies suggest that clinicians should be wary of drug samples and con- sider carefully whether they are actually helping to reduce costs for patients.
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