This may seem like a trick question because, after all, it’s free. How can something that’s free cost anything?
People and professionals have long wondered whether there was a downside to giving away free samples of prescription drugs. Pharmaceutical companies keep doctors’ offices well-stocked on such free samples, so they obviously suspected it was a way to introduce patients to their brand and get them to come back for more. As paying customers.
Now a new study puts the matter to rest and explains why that “free” sample actually results in higher costs — for everyone.
Brand-name prescription medications carry a premium, just as in the rest of the world. You pay more for the brand-name. Drug companies say that money helps cover their R&D costs for all of the failed medications that never come to market. But it also helps cover their huge marketing budgets, which they talk far less about.
Generic prescriptions, on the other hand, save everyone money. Typically, they contain the same active ingredients as the brand-name drug, and have to be show to be “bio-equivalent” to the brand-name drug before they can come on the market. They may cost anywhere from 1/10th to 1/100th the price of the brand-name drug — a bargain in anyone’s book.
Free samples of brand-name drugs are given to doctors’ offices by the pharmaceutical company who makes the drug. Their given in the hopes that the free samples will influence the prescribing behavior of the doctor: “Here, let me give you a free sample of this drug. Oh, and we might as well write the script for the same drug, so you don’t have to deal with any new side effects if I prescribed a different drug instead.”
And that’s the problem — pharmaceutical companies are buying doctor influence through this simple act of giving them the freebies.
The LA Times’ Karen Kaplan has the story:
[… R]esearchers found that dermatologists were still enamored with free samples. In 2010, 18% of all prescriptions they wrote came with a free sample, up from 12% in 2001. […]
The list of top five acne drugs changed considerably between 2001 and 2010, according to the study. But the favorites were usually closely aligned with the drugs that doctors had available for free in their offices.
In 2010, nine of the 10 most popular acne drugs nationwide were either brand-name drugs or branded generics (which companies sell at a premium), and free samples for them are typically available.
Now, guess what happens in doctors’ offices where free samples are not allowed?
In this group, nine of the 10 most popular acne drugs were low-cost generics (which don’t come with free samples).
So maybe that initial trial run of taking the free sample drug saves a patient money. After all, they didn’t have to pay for that first week’s or month’s supply of the more expensive brand-name drug.
It doesn’t seem that the free samples wound up saving patients much money. Those who were seen in private practices walked away with prescriptions for $465 worth of medications, on average, while the patients treated at the academic medical center got prescriptions that cost about $200 to fill. “In other words, the national mean retail cost of the prescriptions received at an office visit for acne is conservatively two times higher compared with the [academic medical center], where samples were unavailable,” the researchers concluded.
But, as the researchers noted, we already knew all of this. Previous research conducted on “free” samples has shown much the same pattern of behavior: docs prescribe more of the free sample drug than generics, when free samples are available in their office. And patients pay more out-of-pocket costs when prescribed a brand-name drug.
Many healthcare systems haven’t taken note of this connection, and banned free samples from their offices. This includes Kaiser Permanente, the VA, and the U.S. military.
So the next time you’re in your doctor’s office and they offer you a free sample, do something different — consider turning it down and ask if a generic is available instead. If a generic is available, you’ll end up paying less for a drug with the same or similar benefits.
Keep in mind, however, that generics are not available for all drugs, and there may, in fact, be legitimate professional reasons a doctor wants to prescribe a specific brand-name drug over a generic. This is an opportunity to have a conversation about it, instead of simply accepting the doctor’s first decision as the final one.
Read the full article: Free samples of prescription drugs are costly to patients, study says
6 comments
Samples only promote dependency and entitlement these days for mental health care meds, take my word for it as a psychiatrist practicing in Community Mental Health clinics most of my career. Oh, and the beauty you will never hear or learn from these companies that operate just like the drug dealers on the street corner giving away their “free product” to hook people is simply this:
“we will supply brand name product, but as soon as it is becoming generic, those samples are gone!”
Those people on SSRI-type meds, even the antipsychotics, you just can’t stop them abruptly, but if you depend on samples and can’t afford those $150-600 a month rates for these scripts, well…
Oh, and interestingly, amazing how generic products aren’t so much cheaper than the brand was sometimes for almost a year after the generic is available.
Health care in this country is a real misnomer for decades now, it is “Health cost” first and foremost.
I still laugh when people use the term “managed care”, what a joke term!
Thank you Dr. Hassman for telling the truth about these poison prescriptions that are being passed out like candy!
My fiancé would still be alive today if that drug dealer he called a Doctor put hishhealth before her paycheck!
I’ve been a retail pharmacist for close to 20 years. I realized after several years working that it is common that brand name drugs either have fewer side effects or are more effective than their generic counterpart. How could this be? Both have the same active ingredient. The inactive ingredients are different, but that shouldn’t matter, they are inactive. I do not believe it is the placebo effect. There are too many cases of hard objective side effects or objective lack of effectiveness to write it off as the subjective placebo effect. Brand and generic ingredients are supplied by different sources at times, and assembled in different factories. Generic supplies and factories may have weak manufacturing standards. This practical effect is very important and is being largly ignored.
My fiancé died in 30 days when his doctor gave him a 30 day sample of ABILIFY for stress! He suffered every adverse side effect associated with the drug and once the Doctor gave him this poison she didn’t know how to treat him. In one month he lost 20 pounds, he couldn’t eat, he hadn’t slept in a month, he had confusion, delusions, hallucinations, face twitches, body jerks, nose bleeds, his blue eyes turned black and HOPELESSNESS and DESPAIR all from one 30 day sample of ABILIFY. To counteract the side effects of the ABILIFY his Doctor gave him MORE FREE SANPLES which made a Toxic Cocktail of MED$. She gave him a FREE SAMPLE of CYMBALTA to stop the hallucinations, VYVANSE an ADHD Drug to help him concentrate at work, WATSON 933 aka Acetaminophen for pain from the body jerks and AMBIEN to help him sleep. Six days later he was dead from a Gunshot Wound to the chest and the side effects to ALL the drugs I listed us SUICIDE within the first week to 30 days. It wasn’t until after my fiancé was dead that I found out that ABILIFY was a Schizophrenic Drug OFF-LABELED to treat a number of disorders like stress, PTSD, ADHD, Autism, Pain, PMS, Cramps and Alzheimers to name a few…
I’ve witness first hand how fast these so called miracle drugs advertised on TV kill.Today the FDA is being run by Pharmaceutical insiders and lobbyist and they are making a KILLING at the patients expense.
When the commercial says that this drug may make depression worse and this drug may cause heart attack, stroke, SUICIDE, and sudden death , that isn’t half of the side effects. What they don’t tell you in the disclaimer is that these so called miracle drugs can cause Violent Crimes, Violent Suicides, Homicides, Murder-Suicides and Mass Murder.
If you notice that at every suicide, murder-suicide, violent crime and mass murder in America, Med$ have been at the scene of EVERY crime!
Dr. Lane and his partners at Stanford are WRONG.
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 prescription.
Please note that this is the same drug, for the same condition as in this JAMA article. A simple “Google†search would have shown this information. Also in the JAMA article, it is disclosed that one of the physicians for this study has given paid testimony on this drug, doxycycline. One would think the physician that is giving paid testimony and doing research on (regarding pricing to patients in this study) may do a little research about pricing issues in the press?
Mylan sells near $7 billion of generic drugs a year. Not there is anything wrong or right with that, but $1000 more a prescription here, maybe they could provide the Doctors here at Stanford some samples? Also their (Mylan) pricing of the EpiPen for sever allergic reactions seems to have some controversy.
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, let’s hope you can go into Costco and Sams and not buy everything a lady gives you a sample of, for we all seem to get though it, and we don’t calculate the price of the samples, and give each company a black eye for
Also note, any pharmaceutical representative would have these physicians aware of the pricing of this drug to show that their brand name drug is actually less. You don’t need to take a sample, but don’t close yourself off from current information going on with these treatments in the marketplace to think your saving patients money. Your patients are loosing, and you seem uninformed of the marketplace, something your patients are not going to like when they go to fill that generic for $1300.00 from Mylan.