Drug Maker Tallies Value of Free Samples

<"http://www.yourlawyer.com/practice_areas/defective_drugs">Drug companies have recently been under fire for all the freebies they pass along to doctors in attempts to prompt prescribing of higher-cost medications. The Wall Street Journal just reported that Pfizer Inc. distributed an astounding 101 million drug samples in 2007—the samples were worth a whopping $2.7 billion.

In mid-2009, we wrote that while the pharmaceutical industry maintains that drug samples are meant to assist uninsured and low-income patients, the practice of physicians in this country giving out such samples has long been debated. In a PLoS Medicine essay, two experts said this practice “has many serious disadvantages and is as anachronistic as bloodletting and high colonic irrigations.”

The Journal cited documents that indicate the broad use of free samples by industry as a marketing tool, which some—including patients and physicians—welcome. Others criticize the practice pointing out safety concerns and the fact that this so-called tool drives sales of expensive brand names when less expensive generics might be available, noted the Journal.

We previously wrote that Susan Chimonas, a researcher at the Center on Medicine as a Profession at Columbia University, New York, and Jerome Kassirer, former editor of the New England Journal of Medicine and a distinguished professor at Tufts University School of Medicine, Boston, argued that the tradition is “not effective in improving drug access for the indigent, does not promote rational drug use, and raises the cost of care.” The two cited research that found many free samples, “are appropriated by physicians for personal or family use,” and that one study found close to half of the industry sales reps surveyed admitted to using samples themselves or doling them to friends and relatives, proving samples are misused and given to the wrong demographic.

The two said, “Indeed, evidence shows that patients who received free samples had higher out-of-pocket costs than their counterparts who were not given free samples.” Because companies look to earn back costly marketing through increased pricing, samples only really serve to raise health care prices.

The Journal cited the health overhaul passed in March that mandates companies advise Congress how many samples they distribute and, while estimates were previously available, Congressional documents viewed by the Journal detail drug-sampling by drug makers in 2007: In addition to Pfizer, Merck & Co. doled out 39 million samples—about $356 million; Eli Lilly & Co. 33 million at $67 million; Wyeth (acquired by Pfizer in 2009), 52 million at $64 million; Abbott Laboratories doled 16 million worth $32 million, and Bacter International Inc. distributed 33,000 worth $7 million. Drug values were based on market price or wholesale cost, said the Journal.

A Pfizer spokesman said samples “enable patients and physicians to try a medicine and evaluate tolerance, assess effectiveness, and adjust dosage before committing to a full prescription regimen,” quoted the Journal, which noted other companies provided similar explanations. Regardless, in recent days, some doctors and facilities, such as the Mayo Clinic and the University of Wisconsin Health System have been limiting sample use over conflict of interest and safety worries, said the Journal.

A 2008 study in the Southern Medical Journal found that doctors in a clinic were more than three times more likely to prescribe generic medications to uninsured patients after drug samples were removed from that clinic. “Free drug samples may lead to higher costs for uninsured patients by encouraging physicians to write prescriptions for brand-name drugs only,” the study said.

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