Should Free Drug Samples Be Banned?

Should Free Drug Samples Be Banned?

Survey began 16 August 2008
Survey ended 13 November 2008

Background

According to The Prescription Project — which is funded by the Pew Charitable Trusts and which “seeks to eliminate conflicts of interest created by industry marketing by promoting policy change among academic medical centers, professional medical societies and public and private payers” — $18 billion a year goes to free drug samples. Other sources confirm that this number is in the right ballpark.

While the new PhRMA Code on Interactions with Healthcare Professionals bans free pens and lunches, it doesn’t apply to samples: “It is appropriate,” says the Code, “to provide product samples for patient use in accordance with the Prescription Drug Marketing Act.”

But the Prescription Project discounts the value to patients of free samples:

• Samples encourage physicians and patients to rely on medications that are expensive, but often not more effective than other available drugs. Research has shown that samples can increase physician prescribing of the marketed product, independent of the effect of detailing by industry sales representatives.
• Samples serve two distinct marketing purposes. Physicians value samples and are willing to spend time with sales representatives to get them. Secondly, samples serve as “starter” medications — an enticement to prescribe new, heavily marketed and generally more expensive medications. Once therapy has been initiated, patients and their insurers are likely to continue to pay for the new, costly drugs.
• Studies indicate that the majority of pharmaceutical samples are not dispensed to low-income or uninsured patients. Nevertheless, many physicians use samples, in part, to provide medications to needy patients. However, the inconsistent availability of samples may limit the utility of this approach.