A physician survey of the effect of drug sample availability on physicians’ behavior

Abstract

OBJECTIVE: Pharmaceutical companies often use drug samples as a marketing strategy in the ambulatory care setting. Little is known about how the availability of drug samples affects physicians' prescribing practices. Our goal was to assess: (1) under what circumstances and why physicians dispense drug samples, (2) if drug samples lead physicians to use medications other than their preferred drug choice, and (3) the physician characteristics that are associated with drug sample use. DESIGN:Cross-sectional survey. SETTING:University-based clinics at one academic medical center.PARTICIPANTS: 154 general medicine and family physicians. MEASUREMENTS AND MAIN RESULTS:Physicians' selfreported prescribing patterns for 3 clinical scenarios, including their preferred drug choice, whether they would use a drug sample and subsequently prescribe the sampled medication, and the importance of factors involved in the decision to dispense a drug sample. A total of 131 (85%) of 154 physicians responded. When presented with an insured woman with an uncomplicated lower urinary tract infection, 22 (17%) respondents reported that they would dispense a drug sample; 21 (95%) of 22 sample users stated that they would dispense a drug sample that differed from their preferred drug choice. For an uninsured man with hypertension, 35 (27%) respondents reported that they would dispense a drug sample; 32 (91%) of 35 sample users indicated that they would dispense a drug sample instead of their preferred drug choice. For an uninsured woman with depression, 108 (82%) respondents reported that they would dispense a drug sample; 53 (49%) of 108 sample users indicated that they would dispense a drug sample that differed from their preferred drug choice. Avoiding cost to the patient was the most consistent motivator for dispensing a drug sample for all 3 scenarios. For 2 scenarios, residents were more likely to report using drug samples than attendings ( P Ͻ .05). When respondents who chose a drug sample for 2 or 3 scenarios were compared to those who never chose to use a drug sample, or chose a drug sample for only one scenario, only younger age was independently associated with drug sample use. CONCLUSION:In self-reports, the availability of drug samples led physicians to dispense and subsequently prescribe drugs that differ from their preferred drug choice. Physicians most often report using drug samples to avoid cost to the patient.

Inventory of Drug Samples in a Health Care Institution

“…Many reasons are given for physicians distributing drug samples rather than writing prescriptions that would necessitate a visit to the pharmacy. [9][10][11][12] According to physicians and other individuals polled (e.g., medical residents, nurses, pharmacists, participants in medical continuing education, pharmaceutical sale representatives), samples save the patient from having to go to the drugstore; reduce the cost of treatment; allow the patient to gain access to new treatments while allowing the physician to develop clinical experience and use new drugs that may not yet be covered by public or private plans; allow rapid initiation of therapy, which may be needed for clinical reasons; and allow the physician to verify short-term tolerance or efficacy before writing a prescription for the usual duration of therapy. The use of samples may even increase the patient's level of satisfaction.…”

“…[9][10][11][13][14][15] For example, the distribution of drug samples may jeopardize the continuity of care, especially as the patient's medication record at the retail pharmacy will be incomplete and the pharmacist is unlikely to meet the patient during the course of therapy with drug samples. These omissions can lead to unintended therapeutic duplication, allergic reactions, intolerances or interactions, doses that are too low or too high, use of contraindicated drugs, and missed opportunities to counsel patients.…”

Medicare Beneficiaries and Free Prescription Drug Samples: A National Survey

“…Some argue that samples lead to overuse of expensive, brandname, medications in lieu of less expensive, evidence-based, treatments. 4 Despite these limitations, we found that 78% of elderly Medicare beneficiaries with CRN accessed free samples. We argue that the needs of these patients should be considered when adopting policies limiting free sample distribution.…”

Influence of Pharma CRM & Personal Selling Strategies on the Prescription Behaviour of Doctors- A Literature Review

“…The most useful research in this direction is probably the sparse literature in medicine that examines the motives of physicians while dispensing free samples to the patients. Such motives could emanate from factors such as: (1) financial savings; (2) convenience; (3) immediate initiation of therapy (4) demonstrating appropriate use of drugs; (5) adjustment of doses; (6) evaluating effectiveness of adverse effects of drugs (Chew, et al, 2000;Duffy and Clark, 2003) Studies (Gönül et al, 2001) have revealed that detailing has a positive and significant effect on doctors prescription of specific brand of drugs. Others find that detailing has a very modest effect (Mizik and Jacobson, 2004) or no effect at all (Rosenthal et al, 2003) on brand prescriptions or sales ( Leeflang et al, 2004) pointed that the incongruent effects of detailing are mainly due to the marketing expenditure made by the firms across different brands.…”