TOPICS > Health

Do free samples influence the way doctors prescribe drugs?

April 20, 2014 at 3:16 PM EDT
A new study from Stanford University's School of Medicine found that doctors who are allowed to hand out free samples of expensive drugs prescribe those drugs more often than doctors who don’t have access to free samples. Dr. Alfred Lane, senior author of the report, talks with Hari Sreenivasan about the implications of the findings.

HARI SREENIVASAN:  If you ever felt lucky that you got a free sample of a prescription drug from a doctor, it may actually be costing you in the long run. A new study from Stanford University’s School of Medicine found that doctors who are allowed to hand out free samples, often prescribe those expensive drugs versus doctors who don’t have access to free samples. We’re joined from California by Professor Alfred Lane, who teaches pediatrics and dermatology at Stanford and is a senior author of the study. So you looked specifically at the practice of dermatology, what did you find?

DR. ALFRED LANE:  Yes, we found that those physicians across the United States who use samples are much more likely to write for higher prescriptions. The average cost of a first visit for acne or rosacea was over $450 for medication for the physicians that use samples. And we compared it to our clinic where we have no samples where the average cost was only 200-hundred dollars. So at least twice as more expensive were the prescription costs from the physicians who use samples.

HARI SREENIVASAN:  And now this was focused on dermatologists and these particular types of medicines. But how does this translate out – is this a wider practice that’s happening in different fields as well?

DR. ALFRED LANE:  Well, the reason for the study is I noticed in my practice once we did not have samples that I was writing for more generics and the patients referred from dermatologists were on more expensive medications. And so we tried to look at it, and in the data we found that it is true that dermatologists are using samples more than other specialties over the last ten years. And a lot of that has to do with the use of what’s called branded generics or generics that now are under brand name, and they’re very expensive.

HARI SREENIVASAN:  So now, the drug companies would come back and say listen, don’t these free samples help the poor who might not able to afford the medications or help them get immediately on the drug?

DR. ALFRED LANE:  That’s what dermatologists and that’s what physicians will often say, but the data is very clear that the poor patients are not the ones who usually get the samples. We didn’t look at that in our study, but that’s been shown in other studies.

HARI SREENIVASAN:  And so is there a connection between the amount of money the drug companies now spend – is this basically, are free samples essentially the marketing right off?

DR. ALFRED LANE: Yeah, so it looks like there’s at least over six-billion dollars a year that are spent by pharmaceutical companies in sampling. And so that cost eventually has to be paid by someone. And the price of the generic drug may be quite a bit less than what’s called brand name or branded generic. And it’s only the branded generics or the branded drugs that are sampled. So those are the ones that the dermatologists are channeled into writing prescriptions for.

HARI SREENIVASAN: And what about the argument that samples are the way to get the most recent medications into the hands of doctors?

DR. ALFRED LANE: Well, sometimes that’s not the best thing. There are studies with cardiovascular disease that sometimes the recent medications are not studied as well, and the risk of death or dying from the use of samples can be there. In dermatology, we don’t see that. But the other problem is that the recent medications have not been proven better than the generic in most situations.

HARI SREENIVASAN: So the six-point-three billions dollars, those are essentially costs passed onto the consumer?

DR. ALFRED LANE: That’s exactly right. And one of the focuses of our study was for the dermatologists to realize that although they think they’re helping the patients, they are really being manipulated to write for more expensive medications with no proven benefit of those medications over the generic drugs.

HARI SREENIVASAN: All right, Professor Alfred Lane joining us from Stanford, thanks so much.

DR. ALFRED LANE: Thank you.