Free Samples: The Drug Rep's Last Great Hope

Armen Hareyan's picture

"As of Jan 1 2009, pharmaceutical reps will no longer be permitted to deliver any marketing materials to [healthcare professionals]. This makes samples our only real form of in-office marketing," according to Chris Nibe, a "Sales Specialist" employed by Daiichi-Sankyo.

Nibe made this comment yesterday at ExL Pharma's 4th Annual Pharmaceutical Sampling Strategies & Alternatives conference in Philadelphia, PA. I attended this meeting as a guest of ExL Pharma and Media Partner who helped ExL Pharma promote the conference.

Of course, these were the personal opinions of Nibe and not Daiichi-Sankyo, which was "not responsible for the content, opinions or research conducted to complete [Nibe's] presentation. Nibe claimed, however, that his "presentation [represents] the views and opinions of Health Care Providers, Pharmacists and Pharmaceutical Representatives." At his side and contributing to the discussion was Alexis Nibe (his wife), a registered physician assistant.

As some readers of this blog and Pharma Marketing News may know, I am currently running the Pharmaceutical Sampling Practices Survey and plan to write an article on this subject for the November issue of the newsletter. What I learned at the conference will be included in that article. But let me just focus on my take-aways from Nibe's presentation, which was entitled "Addressing the Future of Sampling in both Pre and Post Election Environment."

I was a bit disappointed that despite the title of his presentation, Nibe said very little about how the presidential election might affect sampling. Curiously, Nibe asked if we were going to have "socialized medicine" or not? The implication was that this is Obama's plan. The term "socialized medicine" is, of course, a Republican way of referring to the kind of single-payer system prevalent in Canada, Europe and all those other un-American "socialist" countries (and even some US states -- ie, the blue ones).

Whatever! As one attendee said, with a single-payer system, there will be no role for the $11.5 billion in free drug samples the industry hands out to physicians every year (2003 number). Of course that would be true if the "socialized" formulary only included generic drugs or only one brand drug per therapeutic class (eg, only Lipitor for high cholesterol and not Crestor).

Although the industry touts free drug samples as a means by which drugs can be made affordable to some needy patients, Nibe suggested that drug companies must "Crunch the numbers and pay attention to higher volume physicians with larger managed care opportunities." In other words, samples are a strategy to fight certain managed care practices like "step therapy" where a physician is required to first try drugs on formulary and if they fail, then other, non-formulary, drugs may be subscribed. The brand drug strategy is to convince physicians that patients will fail on the formulary drugs and when that happens samples of the brand are readily available.

Sometimes, as Alexis Nibe admitted, healthcare practitioners such as herself subtly guide patients into saying that they have tried a formulary drug and failed. Then they are free to prescribe the brand and distribute the sample. This reminded me of how sometimes children can be manipulated by prosecutors into testifying that a teacher or caregiver sexually abused them.


But back to the drug samples as a sales rep's last great hope. When Nibe referred to January 1, 2009 as the day when free drug samples will be the last form of in-office marketing, he was referring to the effective date of PhRMA's new Guidelines for Interactions with Healthcare Professionals (see PMN Reprint #77-01). Thus, free drug samples -- according to Nibe -- will be more important than ever after January 1, 2009.

Nibe obviously believes tchotckes (free gifts like pens, pads, and clocks) are the only form of in-office marketing other than samples that are available to reps. What about free food, which is still allowed under PhRMA's guidelines? If free pens are marketing tools, so are free lunches!

[BTW, Nibe reported that physicians are "hoarding" tchotckes like 50's era survivalists hoarded food in anticipation of the coming nuclear winter!]

But what about the naive notion advanced by PhRMA that interactions between company representatives and healthcare professionals “should be focused on informing the healthcare professionals about products, providing scientific and educational information, and supporting medical research and education?”

A New Loophole for Distributing Free Pens to Physicians
BTW, I have a way in which samples can help drug companies distribute free pens to docs and still abide by PhRMA's guidelines.

From Nibe's presentation I learned that samples are often supplied in starter kits that include all sorts of booklets and other information meant for patients. Often there is just a single pill and the rest is all fluff (ie, patient education materials).

There is no law or PhRMA guideline that prevents pharma companies from distributing starter kits to physicians. No one, I'm sure, looks inside these kits to see that everything is on the up and up. What if these kits included pens and pads with brand logos meant for patients to write themselves adherence messages?

Physicians can simply "redistribute the wealth" by relieving the kits of these "tchotckes" for their own use. After all, many physicians are already using samples for their own use or for use by their friends or staff and their families. Patients won't even know the pens were included in the kits and I'm sure the physicians and their staffs would not rat out the pharma company and expose this clever "loophole."

Reported by Pharma Marketing Blog.