Drug Samples: Why Not?

Abstract

Dr. Williams, the medical director of a large clinic, announces to her staff, "As of next month, we will no longer be offering free drug samples to patients here." Over the immediate dissent of the doctors, she continues, "I am concerned that, with our limited supply, we are often starting patients on drug regimens that we know we cannot continue to provide for free and that they will not be able to afford once their samples run out." "This is the only way some of our patients can get their medication!" protests one physician.Dr. Williams explains that the office has stopped accepting gifts such as dinners from pharmaceutical companies and says she thinks that this is really just in keeping with those policies.Dr. Silverstein points out that, under the new Physician Payments Sunshine Act, drug samples are exempt from mandatory reporting, unlike material goods, stock options, grants, consulting fees, travel, and other perks. He insists that this is clear evidence that drug samples are unlike these other things the clinic has stopped accepting and that Dr. Williams ought to reconsider her position. In turn, she asks him, are drug samples really helping their patients if they can't receive the full regimen without financial hardship? CommentaryThis case narrative illustrates a common scenario: a doctor tries to find ways to reduce financial burdens to a patient, and one way to do that is to provide drug samples. The case then asks whether drug samples are really helping patients if they can't receive the full regimen without financial hardship. I think the answer is yes, and I provide my reasons for thinking so in this commentary.The rising cost of health care in the US has resulted, in part, from the price of drugs [1]. To market their new products effectively, pharmaceutical companies spend enormous amounts on promotion efforts aimed at physicians, such as gifts, free samples, educational seminars, entertainment, and consulting arrangements. Free drug samples constitute a large portion of pharmaceutical companies' marketing budgets-between 1996 and 2000, slightly more than half of all dollars spent by the pharmaceutical industry went toward promotion [2].

Pharmaceutical marketing: the example of drug samples

“…Physicians' use of prescription drug samples has been debated. Some argue that samples decrease prescribing quality and increase overall prescription drug costs [1][2][3]; while others argue that free drug samples are beneficial for patients [4,5]. In fact, drug samples are a powerful marketing tool.…”