No More Free Drug Samples? / Dangerous Practice

The dangerous and widespread practice of Sample Drug Handout “Experimental” Diagnosis: 1. Try this drug: If it helps, you must be depressed. 2. If it doesn’t help: “Try this other drug, maybe it will help”  3. Keep adding “new” drugs until the patient is a zombie, suicidal, or in jail; blame the patient for “getting worse, not better”.

9b2b2b052b14114816bb22aa8d5520b2This “Guinea Pig” form of “diagnosis and treatment” is OUTRAGEOUSLY reckless and incompetent.  It leads to “diagnosis by drug reaction” and “additive” prescribing – handing out more and more “samples” without discontinuing “ineffective or harmful” medications. I have experienced this type of pressure to be a “Guinea Pig” on too many occasions, with very bad consequences. In one instance the “psychiatrist” using this lazy “technique” thought it was funny, saying to my face, “I hear you had a “bad trip” – laughing as he said it, as though I had taken a psychedelic drug “for fun”. He never acknowledged his carelessness behavior; he did not apologize – or show any “empathy” regarding the traumatic reaction I had suffered.

I called the pharmaceutical company for information (Yes! you can do this) and was told by one of their staff pharmacists, that the drug came with clear instructions that it was NOT to be prescribed or taken by patients with – Guess what? My diagnosis – due to the history of life-threatening side effects. There were ZERO consequences for the psychiatrist who willfully ignored the warning that the pharmaceutical company provided.

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PLoS Med. 2009 May; 6(5): e1000074.
Published online 2009 May 12. doi:  10.1371/journal.pmed.1000074 Link full article

No More Free Drug Samples?

 

Everybody likes something free, and free prescription drug samples are no exception. Patients love to receive them, and doctors feel good about handing them out. The practice of providing free drug samples is based on the tacit assumption that “sampling” does much more good than harm. In two separate news releases within the past year by the Pharmaceutical Research and Manufacturers of America (PhRMA), the trade organization that represents the country’s largest and leading drug companies, a senior vice president claimed that free samples improve patient care, foster appropriate medication use, and help millions of financially struggling patients. He averred further that samples benefit physicians by exposing them to new treatment options [1],[2]. In this essay, we question the assumption that good trumps harm when prescription drugs are provided free to practicing doctors. We argue that “sampling” is not effective in improving drug access for the indigent, does not promote rational drug use, and raises the cost of care.

Health Care Costs

Samples are not effective in lowering patients’ costs. Indeed, evidence shows that patients who received free samples had higher out-of-pocket costs than their counterparts who were not given free samples [21]. Samples raise the cost of health care, as companies recoup marketing costs through higher prices and increased sales volume. Samples constitute an enormous promotional outlay of pharmaceutical companies. Between 1996 and 2000, they accounted for slightly more than half of the total promotional dollars spent by industry [22]. Although there is controversy about how best to tally the amount of money the pharmaceutical industry spends on free samples, a recent analysis of 2004 figures sets the retail value of samples at approximately 16 billion US dollars [23]. The retail value of free samples has risen steadily, doubling between 1999 and 2003 [24] (Figure 1). Sample distribution often intensifies during new drug launches, or when a product is withdrawn from the market and competitors scramble to fill the vacuum [25].

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Figure 1. Retail value of US samples, in billions of dollars.

http://dx.doi.org/10.1371/journal.pmed.1000074.g001

Samples raise health care costs by promoting the use of expensive products. In the US, prescription costs grew 5-fold from 1990 to 2006 [26] and are said to be approaching US$200 billion annually [27]. A substantial fraction of the increase is attributed to a growing reliance on expensive, brand-name medications [28] (Figure 2). One analysis several years ago showed that in a single year, the 50 most heavily marketed drugs accounted for nearly half of the increase in retail spending on prescription drugs (the other 9,850 drugs made up the remaining sum) [29]. These are the very products patients are mostly likely to receive as samples.

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 Figure 2. Factors driving growth in drug spending, 1993–2003.

http://dx.doi.org/10.1371/journal.pmed.1000074.g002

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