A free medical sample may cost you in the long run

ShareThis

Those "free" drug samples docs give out can turn out to be costly in the long run.A new study published this week in the journal Medical Care shows that patients who get the samples wind up having significantly higher out-of-pocket prescription costs than those who don't get the samples from their doctor.Samples are a major part of the $30 billion to $60 billion a year researchers say is spent on promoting drugs in the United States. Physicians vary in how they choose patients to receive the samples, but many believe they're giving those chosen to receive the packets an economic -- as well as medical -- benefit.Dr. Caleb Alexander of the University of Chicago Medical Center and colleagues took data from a national survey of medical spending that included 5,709 patients and followed their experience for up to two years.Patients who never got a sample had out-of-pocket drug costs of $178 over six months. But among those who got free samples, personal drug spending for the six months closest to when they got the samples averaged $244."Our findings suggest that physicians should use caution in assuming that the use of free samples ultimately reduces patients' out-of-pocket prescription costs," Alexander said.While samples may be valuable to patients when the drugs are only needed for a short time, he said, "All too often, physicians and patients end up continuing the medicine initially begun as samples, even though older, less expensive alternatives may exist."Previous studies have shown that free samples can lead to overuse of newer drugs instead of older, cheaper alternatives, but these have typically only looked at one clinical setting and not attempted to measure out-of-pocket costs.Alexander said it's possible that patients who got the free samples were more seriously ill than those who did not, and thus had higher costs across the board. But such differences probably only account for a fraction of the extra costs, he added, and stressed that medicines given as free samples are usually the newest and most expensive drugs.There is a constant tension between drug-benefit managers trying to hold costs down by stressing more use of older and generic drugs and industry sales reps promoting newer products that may be only marginally better.At the same time, an older population with more chronic illnesses is driving up drug use and costs. A recent report from the benefit-management company Express Scripts found that, in 2006, the number of American adults taking at least one prescription during the year rose to 74 percent, up from 67 percent just six years before. And the average number of prescription medicines taken among those taking any drugs rose to 14.3, up from 10.8 in 2000.In all, this drove spending that year up by about $12 billion, despite generic drug use rising to 58 percent during the same six years.Another factor that may be helping to keep prescription-drug costs from soaring still higher was noted in a recent report from the federal Agency for Healthcare Research and Quality. It stated that the proportion of American prescription-drug users who buy from mail-order pharmacies has risen from 9 percent in 2000 to over 13 percent in 2005.At the same time, the share of those who said they typically bought their medicine from drugstores declined from 65 percent to 61 percent. There was also a decline in patronage of pharmacies inside supermarkets and big-box stores, from 32 percent to 28 percent.www.lww-medicalcare.comwww.apha.org(Distributed by Scripps Howard News Service, http://www.scrippsnews.net)