Drug Samples raise patients prescription costs

A study published in the March 24 issue of the journal Medical Care found that patients who receive free samples of medications from their doctors have higher out-of-pocket expenses for prescription medications than patients who don’t receive free samples.  The lead researcher was Dr. G. Caleb Alexander, assistant professor of medicine at the University of Chicago Medical Center.

Data was collected on 5,709 patients who participated in the Medical Expenditure Panel Survey conducted by the U.S. Agency for Healthcare Research and Quality. Survey participants were followed for up to two years. The out-of-pocket costs for prescription drugs for patients who received free samples were as follows: $166 over the six months before receiving the samples; $244 over the six months in which they received the samples; and $212 over the six months following their receipt of the samples. In contrast, the out-of-pocket costs for prescription drugs for patients who did not receive free samples were $178 over six months. 67% of the patients in the survey had private health insurance, and 14% of them were given at least one drug sample during the study period. Patients with Medicaid were less likely to receive samples than those who were younger and had private insurance, according to the researchers.

Dr. Alexander offers several possible explanations for the finding. Patients who receive free samples may be sicker than those who don’t get samples, or those who receive free samples may then later receive and fill prescriptions for the medications that started as free samples. Drugs that are available as free samples are generally more expensive (e.g. brand-name, being heavily promoted) than older, less-promoted generic medications. Dr. Alexander advocates means other than free samples as a way to reduce patients’ prescription drug costs: physicians writing prescriptions for a three-month supply; increased use of generic medications; and discontinuing non-essential medications. In defense of the practice of distributing free samples, Ken Johnson, senior vice president of the Pharmaceutical Research and Manufacturers of America, states that free samples benefit patients at all income levels by allowing them to try out a new therapy without having a co-payment.

References:

Reinberg S. Free drug samples hike out-of-pocket costs. Washingtonpost.com (HealthDay News). March 24, 2008.

Joelle Potts, PharmD. Candidate