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Patients receiving free pharmaceutical samples have higher out-of-pocket prescription costs

Providing free pharmaceutical samples to patients is a major marketing tool for the pharmaceutical industry. Nearly $16 billion was spent on the provision of samples during 2004, twice that spent on direct office detailing to physicians and more than three times the amount spent on direct-to-consumer advertising. However, the benefit of this practice to patients is widely debated. For example, a new study shows higher out-of-pocket and total prescription costs for patients who receive drug samples.

In a study focusing on the relationship between sample receipt and out-of-pocket prescription costs, G. Caleb Alexander, M.D., M.S., and a team of researchers from the University of Chicago and the University of Illinois, used nationally representative data from the household component of the Agency for Healthcare Research and Quality's Medical Expenditure Panel Survey. The study sample consisted of 5,709 patients who received 2,343 samples during the analysis period.

The predicted 6-month out-of-pocket cost for those who never received drug samples was $178. Yet, those who received samples had costs of $244 during the period of sample receipt and $212 for periods following sample receipt. The pattern was similar for total pharmaceutical expenditures. In addition, patients who received prescription drug samples were less likely to continue on the same medication than those who received the prescribed drug from the pharmacy (19 vs. 45 percent).

This study is the first study using rigorously collected longitudinal data to examine the association between pharmaceutical sample use and patients' prescription expenditures. The researchers concluded that although free prescription drug samples may provide some patients with valuable short-term economic relief, an economic burden persists for patients both during and following periods of sample receipt. This study was supported by the Agency for Healthcare Research and Quality (HS15699).

See "Characteristics of patients receiving pharmaceutical samples and association between sample receipt and out-of-pocket prescription costs," by Dr. Alexander, James Zhang, Ph.D., and Anirban Basu, Ph.D., in the April 2008 Medical Care 46(4), pp. 394-402.

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