Examining No-Cost Prescription Drug Samples

Ruzanna Harutyunyan's picture

USA Today on Monday examined how no-cost prescription drug samples can influence physicians' prescribing habits and how health systems across the U.S. are beginning to ban or limit the samples.

According to a study published in September in the Southern Medical Journal, more than 90% of U.S. physicians receive no-cost samples and more than half of older patients report getting at least one sample in a given year. The study also found that physicians at one practice were three times as likely to prescribe less-costly generic drugs to uninsured patients after the practice stopped storing sample drugs in 2000.

David Miller, a co-author of the study and a general internist at the Wake Forest University School of Medicine, said, "There is a perception out in the general public and in the medical community that drug samples are a great way to provide free medication to people who have trouble affording it."


However, he added that drug samples prompt physicians "to prescribe these more expensive brand-name drugs," while without samples, "their decision on what drug to prescribe is what's best for the patient." Other recent research suggests that insured patients are more likely to receive no-cost drug samples than the uninsured. One study found that few needy children received no-cost drug samples because their families could not afford the physicians who dispensed them. A separate study found that 13% of insured U.S. residents received at least one no-cost sample in 2003, compared with 10% of people who were uninsured for part or all of the year.

Ken Johnson, senior vice president of the Pharmaceutical Research and Manufacturers of America, said, "While it is true that poor and uninsured patients are not the only recipients of drug samples, a patient's financial situation is a factor physicians often consider when distributing such samples."

The University of Pittsburgh Medical Center and School of Health Sciences "have created a unique compromise" regarding no-cost samples as part of a new conflict-of-interest policy, according to USA Today. Beginning April 1, 2009, the university no longer will accept drug samples from pharmaceutical representatives. Barbara Barnes, a medical center vice president, said that physicians instead will be able to order samples online from the eSample Center, a "virtual sample closet" launched last month, and participating drug manufacturers will ship the medications at no cost.

In January 2008, North Carolina-based Carolinas HealthCare System "went a step further" and banned its more than 700 physicians from accepting or dispensing drug samples but provided physicians with vouchers to be given to patients who cannot afford to try certain drugs, USA Today reports (Rubin, USA Today, 12/1).

Reprinted with permission from kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, and sign up for email delivery at kaisernetwork.org/email . The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation. © 2007 Advisory Board Company and Kaiser Family Foundation. All rights reserved.