Free Drug Samples not Helping Poor or UninsuredJan 4, 2008 | Parker Waichman LLP
Free drug samples are not going to the people who really need them, proving that this supposedly generous gesture of medication giveaways is just another marketing ploy on the part of drug companies. Although the pharmaceutical industry maintains that drug samples are meant to assist uninsured and low income people, a study of prescription use by nearly 33,000 U.S. residents during 2003 found that the neediest were least likely to get samples. According to a study released today, insured and wealthy Americans were more likely than the poor to receive billions of dollars in free drug samples distributed by pharmaceutical companies to help win patient and doctor loyalty. "Our findings suggest the free samples serve as a marketing tool, not a safety net," said Dr. Sarah Cutrona, co-author of the report to be published in the February issue of the American Journal of Public Health. Drug samples are popular among doctors who are looking to try new drugs. The Pharmaceutical Research and Manufacturers of America, a trade group representing most major drug makers called the study out-of-date and said a major facet of the problem is that many uninsured do not receive their healthcare from doctors' offices.
"As important as free pharmaceutical samples are in improving healthcare, they represent one—not the only—option for patients in need," said Ken Johnson, a spokesman for the group. Lack of access to regular medical care by the uninsured and underinsured is a major factor contributing to who receives free drug samples, the report said. Nearly 47 million people living in the U.S. do not have health insurance and this group is most likely to seek their care from emergency rooms and clinics.
About $16.4 billion in drug samples were given out in the United States in 2004, up from $4.9 billion in 1996, the study said. Distributed by sales representatives, samples are nearly always the newest, most expensive drugs, the report said. Critics have said that in addition to steering doctors and patients to pricey drugs, samples can lead to medications being used for conditions they were not intended to treat. It is illegal for drug makers to recommend or market drugs for uses for which the U.S. Food has not approved them and Drug Administration (FDA); however, doctors can prescribe drugs for any use.
The study analyzed U.S. government data in a 2003 nationally representative survey, and found that about 12 percent of Americans had received at least one free sample. About 13 percent of those with insurance were given a sample, while about 10 percent of those who were uninsured for all or part of the year received one. Seventy-two percent of those who received a sample had income in excess of 200 percent above poverty level, while 28 percent had income below poverty level. William Shrank, a physician at Boston's Brigham and Women's Hospital who studies pharmaceutical use in large populations, said the study helps debunk the assertion that drug samples help the needy. Brigham and Women's Hospital bans sales representatives, but Shrank described how early in his career he worked at academic centers where representatives freely roamed the halls. For doctors short of time and unable to keep up with medical literature, "You are getting biased data. It's not objective," Shrank said.