Free drug samples may have unintended negative consequences for the uninsured

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A study at Wake Forest University Baptist Medical Center revealed that free drug samples provided to physicians by pharmaceutical companies could actually be costing uninsured patients more money in the long run.

The study looked at the prescribing habits of more than 70 physicians in a university-affiliated internal medicine practice in the months immediately before and after the closing of their drug sample closet. Data from the study indicate that the availability of free samples from pharmaceutical companies greatly impacts whether an uninsured patient is given a prescription for a generic or a brand-name drug.

Study authors used a pharmacy database to track all of the prescriptions in four classes of chronic medications given to uninsured and Medicaid patients. Almost 2,000 prescriptions categorized as antihypertensives (blood pressure medications), oral diabetic agents, peptic ulcer and gastroesophageal reflux medications, and non-narcotic pain medications, were tracked for the nine months leading up to and following the relocation of the practice, at which time the drug sample closet was permanently closed due to a lack of suitable storage space in the new building.

Researchers found that for uninsured patients, the percentage of medications prescribed as generics rose from 12% to 30% after the clinic closed its drug sample closet. For Medicaid patients, however, there was no significant change in generic prescribing. Drug samples are available only for brand name drugs, which are often newer, more heavily advertised and almost always much more expensive than generic drugs in the same class.

David P. Miller, MD, lead researcher and internal medicine physician at Wake Forest Baptist said that although samples can save patients money in the short-run, the study showed that they may end up paying more down the road when they are given prescriptions for brand name medications.
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