Thursday, January 03, 2008

Most drug samples don't go to uninsured

Here's a study you'll find very interesting. The conventional wisdom (some would call pharmaceutical spin) is that free drug samples go to the poor and uninsured. Well, researchers at Harvard Medical School and the Cambridge Medical Alliance will publish a study in the February edition of the American Journal of Public Health which shows the contrary (Boston Globe).
Less than one-third of all people who received samples in a 32,000-person, nationally representative survey had low incomes, and less than one-fifth who got the free drugs were uninsured at any point in 2003.
Of course the pharmaceutical industry is calling this a flawed study - Duh! Now, don't get me wrong. The industry does some good things. There are some drug reps in my area who have gone out of their way to make sure some of my uninsured patients get the prescription meds that they require. I've also had many of my patients take part in pparx. I mean in 2004, approximately $16.4 Billion free samples were given out. However, the researchers also had these interesting findings...
Insured people with better access to medical care were more likely to see their doctors in offices, rather than hospital emergency rooms or hospital clinics. Patients who saw their doctors in offices were more likely to be given free drug samples.

"That finding suggests that the samples were a marketing tool and not a safety net because the poor and uninsured patients were not finding their way to where the samples were," [lead author, Dr. Sarah] Cutrona said.
To me, free drug samples are a two-edged sword. On the one hand, for my uninsured and economically disadvantaged patients, these samples are a kind of life line. And, in the economically troubled times of the community which I live, the young and healthy people are leaving to find work - which leave the older and sicker population. I know some offices around here who do not accept samples, and I understand their reasoning. But, that has to be tough on their patients.

On the other hand, when patients know we have samples of a particular medicine, their persistence on asking for samples can get frustrating at times - especially if I know they have insurance, a decent prescription plan, and know that they can afford to get the medication. It's not for me to judge, but it seems to me that samples for some people are a convenience rather than a necessity.

So, were/are samples a marketing tool? That's an interesting debate to have. I understand both sides of it, and I know people will leave comments probably on both sides of the issue. Our office continues to accept drug samples - along with its benefits and potential perils. What do you think? Are free drug samples a good thing or not?


None said...

You're right, it is a double edged sword. Quite honestly when I see the reps roaming the halls, I often scoff at them, thinking what else do you do except give out samples and bring lunch? I've even challenged some of them with questions on their products, and they referred me to the glossy or told me they'd "have to get back to me". But, I do know here in the health dept., and even some of the PMDs in the area offer the samples to the underserved. I guess all in all, it's up to the provider to decide who gets them. I've gotten samples at my PMD before, and I sure didn't mind. It's probably a situation where the dirty side of marketing is outweighed by the benefit of those getting the samples for free.

Rositta said...

I have had the benefit of drug samples for arthritis, migraine and bladder control issues and I think they are a good thing. Especially the migraine drug that costs a ridiculous $125 bucks for 4 pills! Now that the samples have dried up I suffer through the migraines, I can't afford those prices...ciao

Anonymous said...

I think samples can be a good thing.

I agree that whenever possible they should be reserved for those who need them the most - i.e. the poor, uninsured, etc.

In my case however, I have been known to have weird reactions to drugs that most people have no problems with. (for instance I STOP breathing if I take benadryl)

As a result, my doctor always gives me a small packet of samples when prescribing me something new, just in case I can't take it.

This helps me by allowing me to find out before I get prescription filled if I'm actually going to be able to handle the medicine.

My Own Woman said...

You make a good point when you address the fact that samples are given to the primary care doctor whose patients (most often) have some type of insurance coverage.

In the ER, we are not permitted to take samples and are certainly not permitted to dispense them. I think it's a legal issue or something; but it sure would be nice to give a patient without prescription coverage some samples of Augmentin for a dog bite since the med works the best for dog bites and is expensive.

Dreaming again said...

With Myasthenia, drugs are a hit and miss. Drug samples save a lot of trouble in knowing if it is safe for me to take a drug or not.

I do have issue with the drug reps walking up PAST me while I'm waiting to sign in at an obviously busy doctor's office and just going on back. (even when there are signs up at said doctor's office that says Drug Reps sign in HERE ...and or Please make an appointment, you will not be seen on walk in basis)

They just walk on and over patients as if we don't exist. Hello?