Pricier Rx If Docs Get Free Drug Samples

At least for dermatologists, access to free drug samples from Big Pharma representatives means costlier prescription for patients. That’s the finding of Stanford University Medical Center researchers who published the results of their study April 16th in JAMA Dermatology. A release from the center notes that the findings “are likely to add fuel to an ongoing debate about whether free drug samples are beneficial or instead skew the prescription tendencies of doctors to favor brand name drugs at the expense of patients and their health insurance companies”.

Although studies have shown that most physicians do not believe that the availability of free samples affects their behavior or recommendations for patients, the researchers found that the average retail cost of the prescriptions written by dermatologists with access to samples are about twice the cost of prescriptions written by dermatologists at an academic medical center where such samples are prohibited.

The release quotes senior author Alfred Lane, MD, emeritus professor of dermatology and of pediatrics at Stanford, as saying, "Physicians may not be aware of the cost difference between brand-name and generic drugs and patients may not realize that, by accepting samples, they could be unintentionally channeled into subsequently receiving a prescription for a more expensive medication."

The researchers found that branded drugs (those still under patent to a particular company) and branded generics (a term that describes an alternative dosage or new formulation of an off-patent drug sold under a new name) comprised 79 percent of prescriptions written by dermatologists nationwide, but only 17 percent of those written by physicians at an academic medical center that prohibits its physicians from accepting drug samples. Branded drugs and branded generic drugs often have similar retail prices.

In contrast to some medical specialties, the percentage of prescriptions written with a sample by dermatologists increased from 2001 to 2010 from 12 to 18 percent. The proportion for all other specialties decreased during the same time period from 7 to 4 percent.

The impetus for the study was a policy instituted in 2006 by Stanford Medicine, prohibiting its physicians from accepting samples or other industry gifts. After the change, Lane noticed a discrepancy between the medications he tended to prescribe and those prescribed by other physicians in the community.

"I realized that patients were referred to Stanford with prescriptions for newly introduced, branded generics that were unfamiliar to me," Lane said. "Sometimes I had to look up what they actually were. It wasn't clear to me that there was much benefit to these drugs, and they were definitely very expensive."