Why Free Drug Samples Lead to Higher Drug Costs

A new study published in JAMA Dermatology gives yet more evidence that theres no free lunch in the medical industry. This study found that when doctors receive free samples from pharmaceutical companies, they’re more likely to prescribe the expensive, brand-name medicine even if other drugs, including generics, are available and equally effective.

As analyzed by a story on NPR, the JAMA study showed that dermatologists who accepted free brand-name acne drugs were likelier to prescribe the expensive medications than doctors who are forbidden from accepting samples. And the difference in cost is not marginal.

The average cost of medicines prescribed by docs who accept and distribute freebies is $465 per office visit. It’s about $200 for patients who see doctors who can’t hand out samples.

One practitioner, who wasn’t involved in the study, told NPR, “When a doctor gives a sample to a patient, it’s a very strong endorsement of a drug. Patients think the physician has chosen this sample because it’s the best drug for them. They don’t realize that the doctor might have chosen it because a drug rep gave him samples and it was what he had around the office.”

Once somebody gives a patient a free trial drug, it’s difficult for some docs to prescribe a different generic drug, because it looks inconsistent. So some physicians, not just dermatologists, end up prescribing an expensive branded drug when a less expensive option is available. And most physicians, according to the study, don’t even realize the influence free samples have on costs.

The researchers analyzed the prescribing habits of 3,500 dermatologists in private practices across the country. They compared that data with prescribing patterns at Stanford University clinics, where doctors aren’t allowed to take samples from drug companies.

The private practice doctors recommended brand-name medications for almost 8 in 10 patients. The Stanford clinic doctors recommended name-brand medications only 1.7 in 10 times.

The experience of the Stanford clinicians is very telling, too, about patients’ perceptions and expectations. When they stopped accepting free dugs and giving them away, patients complained. NPR said one recent study, “Why Didn’t Your Doctor Prescribe A Generic? Look In The Mirror,” found that more than 1 in 3 doctors surveyed sometimes prescribed a brand-name drug because a patient requested it, even when a generic version was available.

Sometimes, it is good medicine and good economics for practitioner to provide samples, especially when patients don’t have insurance coverage or are on tight budgets. Some brand-name drugs are available in different doses or in a time-release formula, which can be more convenient or better absorbed for some people.

But it’s largely the patient’s responsibility to ensure their drug bill isn’t being inflated unnecessarily. That’s not expensive only for the individual, it raises everybody’s health-care costs.

As we’ve always advised, when your doctor prescribes a medicine, ask:

  • Why is this the best treatment?
  • What will happen if I don’t take it?
  • Are there alternatives and/or a generic version?
  • When can I expect to see results?
  • What are the side effects, and how likely am I to experience them?
  • What are the risks?
  • Are there foods or other medicines I should avoid when taking this medicine?

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