While many doctors have transformed their offices into No Drug Rep Zones, many, including myself, still accept free samples of drugs to give to our uninsured patients.
But a steady drumbeat of research is showing that free samples are ultimately more expensive, and may even be unhealthy. The current issue of the Southern Medical Journal reports that free samples actually cost patients more in the long run, because they encourage doctors to prescribe more expensive drugs. Researchers tracked the prescriptions written by 70 doctors in a large internal medicine practice. During the first 9 months of the study, doctors had access to free samples, but halfway through the study period, the medical offices moved to a different building, resulting in the sample closet being closed for 9 months. This provided an ideal accidental experiment for seeing whether samples lead doctors to prescribe more expensive brand name drugs. In fact, during the first 9 months, only 12% of prescriptions were for generic drugs. But during the 9 month sample-free period, prescriptions for cheaper and therapeutically equivalent generics nearly tripled to 30%.
Those who argue that the doctors prescribing brand name drugs were providing more modern and therefore better care would do well to read this study from 2002, which showed that uninsured patients who were given free samples of blood pressure medications had higher blood pressures than patients who did not receive free samples, implying that use of free samples leads to suboptimal treatment.
In fact, the popular notion that samples are given primarily to uninsured patients is untrue, according to an article published recently in the American Journal of Public Health. Researchers analyzed data from a nationally representative sample of 32,681 US residents, and found that the poorest third of respondents were less likely to receive free samples than were those with incomes at 400% of the federal poverty level or higher.
The data are clear. Free samples are simply another marketing tool for drug companies. I guess it's time for me to empty out my sample closet!