An Inside Peek: How Much the Drug Industry Supports Samples for Indigent Patients

Every time I have heard anyone representing the pharmaceutical industry's point of view defend physicians' cozy relationships with detail people, the case is argued that these relationships yield free samples for the docs, who then can give some of these samples to their indigent patients. In HOOKED, I discuss several reasons why this system is a flawed way of getting drugs for the indigent.

Whether or not this is a good way to provide drugs for those otherwise unable to pay, I found it interesting to compare the standard industry rhetoric with an insider's view of what the average drug company may think of this practice.

Thanks to Adriane Fugh-Berman and Shahran Ahari (see next post), I had my attention directed to an October, 2004 article in Pharmaceutical Executive: http://www.pharmexec.com/pharmexec/article/articleDetail.jsp?id=129291

The article, which is mostly about how to package sales reports so that the data make sense to the reps in the field, has a sidebar story, "Customization Case Study." (You have to click separately on that part of the story to read it.)

The sidebar tells how one drug company increased its market share by 86% using several techniques. Included in what they achieved were "reduc[ing] cannibalized prescriptions from oversampling," "reduc[ing] rep calls on low potential subscribers by 27 percent," "decreas[ing] sampling costs by 24 percent," "reallocat[ing] samples to high-opportunity prescribers most receptive to sampling as a promotional vehicle," "identify[ing] prescribers who were oversampled and take corrective action immediately."

If I translate all this into plain English, it seems to be saying: the reps were beat up by their managers to pick out the docs who actually gave a lot of samples to indigent patients, and who accordingly wrote fewer prescriptions for the drugs; those docs were given many fewer samples. Instead, the docs who used the samples "properly"--that is, as a prelude to actually writing prescriptions for well-insured patients who could afford the drugs--got more samples.

The report went on to conclude triumphantly, "No longer oversampled by reps, low prescribers cut back on giving patients free samples and began writing more prescriptions."

So much for the industry making it possible for docs to give free samples to the needy.