Wednesday, December 18, 2013

What’s in the “Free” Sample Closet? Very Little of Value

I’ve blogged about the issue of sample drugs in doctors’ offices mostly in the earlier years of this blog, except for one post this past spring:

Now we can add a study published a while ago by a medical student, Kari Evans, from University of Arizona, and Drs. Steven Brown and Gerald Smetana:

 The folks (I’m guessing they sent the student) snooped into 10 sample closets of primary care offices in Phoenix and made a list of 23 different medications that they found in 7 or more of the closets. They then asked: Is this medicine novel? Is this medicine useful? They had formal criteria for judging each of these variables. They found that 22 of the 23 had a cheaper generic medication available for the same condition, and that only 3 medicines had scientific evidence of superior patient outcomes.

In short, had the docs not had these samples to give out to patients, it’s hard to imagine that the patients would have been any worse off, or that the docs would have missed a chance to become informed about an important breakthrough in medical science.

The study also nicely illustrated why companies give out “free” samples. The mean cost of a month’s supply of the 23 drugs was $178, with the highest-cost drug ringing up a bill of $749. If a patient can be hooked on these meds with free samples, and then the prescription is continued later on, you see how much the company stands to gain—especially knowing that almost all the meds have cheaper generic alternatives.
Just a bit more evidence as to why the sample closet ought to go—and if you’re interested in the issue in any depth, the article provides an excellent review of the previous literature.

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