According to an editorial in the journal JAMA Dermatology, ″Drug Samples in Dermatology,″ pharmaceutical drug companies have been using a clever way to sell more product. They give it away. These free drug samples may have a health cost hidden among the perceived benefits, however.
Patients and doctors alike have been tempted to think of pharmaceutical drug samples as bringing a health benefit to everyone. With a few free pills or tubes of ointment, a patient’s drug costs may come down, and provide a way for a more effective new drug to take the place of a less effective generic or other medication. More effective treatments are then likely to reduce costs.
However, when a doctor gives pharmaceutical drug samples to a patient in the office, there is no need for a pharmacist. If a patient takes medication from her dermatologist there is no way to check this treatment against other pharmaceuticals she may be taking and the health costs may be quite large. Drug interactions are a major cause of death.
The FDA reports that there are 100,000 deaths yearly as a result of adverse drug reactions and over 2 million total adverse reactions. The FDA states that ADRs are the 4th leading cause of death, beating out pulmonary disease and diabetes, among others, for the position.
Already, according to the JAMA Dermatology article, major health care providers such as Kaiser Permanente, the Veterans Health Administration, and the US military refuse to take pharmaceutical drug samples in favor of protecting their patients health. The threat free drug samples pose is not a new discovery.
It is curious why the cost of free drug samples has taken so long to be realized by so many health care professionals, but the problem may be systemic. When doctors feel that they are scientists, they tend to think that they are immune from marketing tactics employed by pharmaceutical representatives. However, the Markkula Center for Applied Ethics at Santa Clara University sees it another way. An ethicist there considers free drug samples to be advertising just like any other.
E. Haavi Morreim’s article, ″Prescribing Under the Influence,″ cites a 1982 study which demonstrated how physicians were swayed by the perceptions pushed by pharmaceutical drug representatives over and above the actual scientific literature. In the study, 71 percent of the doctors polled held false beliefs about the cause of dementia, preferring to believe the information given them by pharmaceutical sales representatives.
In fact, this problem does not end with free samples. Independent news organization ProPublica conducted a major study of the pharmaceutical drug industry’s influence on doctors. In a series titled, ″Dollars for Docs,″ it was discovered that 2.5 billion dollars in disclosed payments were made to doctors from pharmaceutical companies in exchange for various services. In some cases, a doctor only had to travel to an exotic locale and give a short speech in exchange for travel costs plus a healthy stipend.
Patients and physicians may only now be discovering the health cost pharmaceutical drug samples have, but the issue is one which deserves attention. When weighed against the potential for major injury or even death, it is worth it to pay full price for drugs which can be monitored by a pharmacist. Further, if there is a clear record of a prescription then there is full accountability for everyone concerned.
By Hobie Anthony
Sources:
Food and Drug Administration
Santa Clara University
ProPublica
JAMA Dermatology
LA Times
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One Response
The system shows that the average wholesale price of 100 doxycycline pills made by Watson with strength of 100 milligrams is $328.20. The same number of doxycycline pills at the same strength made by Mylan cost $1,314.83.
http://articles.latimes.com/2013/mar/07/business/la-fi-lazarus-20130308
Now that is nearly $1000.00 difference on one generic prescription.
Please note that this is the same drug, for the same condition as in this JAMA article from these Stanford physicians. A simple “Google” search would have shown this information. There is numerous stories on generics out of control on their prices, and those companies have a hard time saying they are putting it into R&D. Also in this JAMA article from Stanford, it is disclosed that one of the physicians for this study has given paid testimony on this drug, doxycycline from Mylan. One would think the physician that is giving paid testimony from this company and doing research on the same generic drug, (regarding pricing to patients in this study) may do a little research about pricing issues in the press in 2013?
Mylan sells near $7 billion of generic drugs a year. Not there is anything wrong or right with that, but $1000 more a prescription than another generic company, maybe they could provide the Doctors here at Stanford some samples? What is Standford’s reply to this? Also their (Mylan) pricing of the EpiPen for sever allergic reactions seems to have some controversy over the past couple of years.
Yes, generics are usually less expensive, but that was very typical of 1980’s and 1990’s pharmaceutical economics. Now with some of the larger generic companies controlling the marketplace, prices have risen for many generics to levels above branded alternative therapies.
Finally, Docs, your smart enough I hope to not have a free sample have you make wrong decisions. Ask your patients on the next visit about the cost of their medication, simple communication will go a long way versus doing a computerized research from a data company on sampling. You’re prescribing the exact drug that has been all over the press as over priced by nearly $1000 a prescription. That is two times the cost you quote in your study.