I was recently made aware of an article on MSNBC which alleges free drug samples provided by doctors actually end up costing the patient more money over time. This, of course, is completely counter-intuitive, and I, not in the habit of taking health information from news sources, looked it up.
And yes, it is, in fact, the case that some studies indicate that those who get free drug samples from their doctor actually end up paying more money in the long-run.
How can this possibly be?
Do Free Drug Samples Cost the Consumer More Money?
Well, that depends on who you ask.
First off, for some reason insured and higher-income folks tend to receive more drug samples than their uninsured and less-income counterparts. (Although not all research agrees on this point.) Why? Well, I’m not sure, but if I had to guess I’d say that rich (or insured) people go to nicer clinics where there are more free drug samples to pass around. Poorer (or uninsured) folks tend to go to less expensive clinics where more people are vying for the same number of free drug samples. But that is just a guess on my part.
And while it’s convenient not to go to the drugstore (and sometimes even necessary due to severity of illness) and additionally convenient to trial several drugs for free before settling on one for which to pay, really it’s those who can’t afford drugs that should be receiving the free samples (if you ask me).
Secondly, some studies report that by providing free drug samples, the patient’s out-of-pocket expenses for drugs actually increases.
Well, Maybe Free Drug Samples Don’t Cost More Money
Of course, depending on the study, some researchers have shown that free drug samples do, in fact, cost patients less, although the benefit may be marginal.
Free Drug Samples are Marketing Tools
And whether you believe free drug samples cost patients more money or not, make no mistake about it, “free” drug samples are, in fact, marketing tools. Pharmacology companies aren’t providing free samples out of the goodness of their heart (assuming they have one), they are providing free drug samples because they know that it increases the chance that their branded medication will be prescribed over their generic medication. And research definitely bears this last point out. (This may be even more true for psych meds.)
And naturally, while generics can be every bit as effective as brand medication, drug companies don’t make money on generics – only their brand. (Although generics are very good for the consumer, costing up to 80% less than the brand name in the United States. In case you were wondering, the difference is only about 20% in Canada because we don’t allow the kind of brand name prices seen in the US.)
Are Free Drug Samples Good or Bad?
Considering the conflicting information, I believe it comes down to the prescriber. Some doctors are quite capable of making good free drug sample providing decisions and this can lower the prescription cost, particularly for those who are needy. However, free drug samples can affect prescribing practices in negative ways and not only cost more money but stick you with a brand medication when a generic might be just as good.
So, me personally? I’m a fan of free drug samples. I think it’s the only way that many people could receive the medications they are currently on. But it comes down to the responsibility of the healthcare provider – as prescriptions always do.
When I was a county consumer I survived by way of samples. Samples allowed me to use medications that were not otherwise covered by medical. I am thankful to have “proper” insurance now mostly because the stigma associated with being on government assistance but the real life benefits are less appealing. I probably would have settled with cheaper drugs at the cost of increased side effects if I hadn’t been spoiled by free samples of more expensive medications.
Gina,
I understand and you’re not the only one.
But like you said, you probably would have settled for cheaper (likely generic and older) drugs if you hadn’t been “spoiled” by the expensive drugs. Marketing works. But with insurance, it’s OK for you (and great for the drug companies).
– Natasha
It’s makes no difference to me as in BC I am in welfare, which means class C exemption: all my psych drugs are free, anyway.
Certainly good for you but I’m sorry to say most people don’t have this option.
– Natasha
I can only speak for myself. I don’t know how this effected my costs/other patients costs, but when I needed $720 per month Geodon, my doctor gave me 2 1/2 months in free samples b/c I couldn’t afford it.
He treats a lot of Medicare patients and uninsured patients. He allows patients who don’t have insurance or are on Medicare/Medicade to make payments. He’s a good doctor.
Now he may very well charge more for these benefits, but I have been seeing him for 4 years and his office visits haven’t gone up on price in that time.
I am thankful for samples. When the time came that I actually needed some, they were available for me.
But, I can see that they could cost more for everyone in the long run. I don’t know which way is correct. But it’s an interesting debate.
Hi Wayne,
If I speak of my personal situation, I have similar experiences.
One of the arguments one might make though is, is there another drug that would have been better for your than Geodon, but was generic? If so, it could have saved you money in the long-term. That would be one of the points people try to make about drug samples is that they “hook” you on the expensive medications. I’m not suggesting that’s what happened for you, I’m just saying that would be an argument others might make.
In my perspective, good doctors use samples well. And it sounds like that may be what happened for you.
– Natasha
Having worked in medicine for decades I can make a couple of position points on this (and I admit to not going back and reading your source material, but I still get the ‘non-consumerized’ versions of several peer reviewed e-sources and keep up with them pretty well.)
In my experience there are three places where drugs samples Absolutely should be used if available (and they almost always are);
1) when there is doubt about adverse side effect or efficacy of a given medicine over another and both are eeegawds expensive. it would be bordering on criminal for me to send a patient out with two prescriptions both in the >$100 range, just to see which one is better tolerated. Drug companies are lavish with their sampling of these kinds of meds (at least in ophthalmology) because they know that pending the outcome of the trial there will be future rx for their product. If it’s a well tolerated and effective product the patient is more likely to be compliant, and thus get their prescriptions refilled regularly as they should.
2) When the condition is acute, contagious and the patient, for lack of insurance or otherwise is unlikely to fill the rx. I remember when Augmentin came out; it was $8-9/pill in late 80s-early90s dollars. Fair lure to treat that case of walking pneumonia means a week or ten days from now you’re going to be seeing a lot more cases of walking pneumonia. Wash, rinse, repeat.
3) For the patient who fall “in the crevasse” because it’s not a crack, it’s big and deep and getting bigger. These are the who may have basic health coverage for doctor visits, but no rx coverage. They’re too well off (or too proud) to be on State Aid or the Pharmaceutical Industry Patient Assistance Programs. Used to be every company as a condition of getting a drug approved had to also have a mechanism to get it to those patients who need it but can’t afford it. Unless the law has changed since my retirement, EVERY company that does pharma business in the US must have a Patient Assistance Program. They’re often hard to find and usually require some active action on the doctors’ office part — I’ve personally filled out hundreds — and some of my colleagues whined about filling out a few. (there’s a special, Dark Place for them, but that’s another soapbox) Unfortunately, some of these also have income guidelines or other criteria that are difficult to meet. (the day laborer with no fixed address, the undocumented alien who has a child born here…) Administratively a furball, but a decent and credible option if you make the cut.
That uninsured/underinsured person will likely become a much bigger burden on the healthcare system if their hypertension, diabetes, COPD are not treated. Samples may be their only or best accessible way — or a bridge to compliance while they wait for Patient Assistance to come through. As we know, head meds do not take kindly to irregular dosing, and in lots of cases make the patient worse. But if you have a choice between rice and beans and occasional ramen if you take a med only twice a week or only rice if you take it every day it’s not hard to see how some patients never find their way out of the crack.
Hi Robbie,
Well, it’s a lot of source material, I can’t really blame you for not looking it all up. :) I simply had to be thorough due to a particularly aggressive individual who has been talking about me on Twitter and suggests I don’t know how to make rational arguments.
And I totally agree, it _is_ a crevasse (especially in the US) and it _does_ cost the healthcare system more in the long run _not_ to treat people appropriately. I wish there were enough free drug samples to go around for that sort of thing but I fear there isn’t.
– Natasha Tracy