The Trouble With Samples And Uninsured Patients
5 CommentsBy Ed Silverman // September 8th, 2008 // 3:15 pm
Free drug samples provided by drugmakers to doctors could actually be costing uninsured patients more in the long run, according to a new retrospective study in the Southern Medical Journal.
The retrospective study looked at the prescribing habits of more than 70 physicians in a university-affiliated internal medicine practice in the months immediately before and after the closing of their drug sample closet. The results indicate that the availability of free samples greatly impacts whether an uninsured patient is given a prescription for a generic or a brand-name drug.
Researchers from Wake Forest University Baptist Medical Center used a pharmacy database to track nearly 2,000 prescriptions in four classes of chronic meds - blood pressure, diabetes, peptic ulcer and acid reflux disease - given to uninsured and Medicaid patients.
They found that, for uninsured patients, the percentage of meds prescribed as generics rose from 12 percent to 30 percent after the clinic closed its sample closet due to lack of storage space. For Medicaid patients, however, there was no significant change in generic prescribing.
“It’s true that samples can save patients money in the short-run,” David Miller, the lead researcher and internal medicine physician at Wake Forest Baptist, says in a statement. “But our study shows that they may end up paying more in the long run when they are given prescriptions for brand-name only drugs.”
Dan A.
yet, I recall another study that suggested poor or uninsured patients do not get the samples compared with other patients. so which is it?
Mike M
Two different questions. When uninsured patients happen to be given samples, it costs them more in the long run. However, data show that these patients do not receive samples as much as their insured counterparts. Bottom line, free samples aren’t free even when the people who may need them most are the beneficiaries.
Jack2
The link doesn’t work so I can’t read the whole article.
But…a generic rate of 12 or 30 percent is ridiculously low. It should at least be greater than 50%. Something is fishy about that number compared to everywhere else.
They found that, for uninsured patients, the percentage of meds prescribed as generics rose from 12 percent to 30 percent after the clinic closed its sample closet due to lack of storage space.
Ed Silverman
Hi Jack2,
I just fixed the link. Thanks for letting me know.
ed
Tom Kaye
Providing samples to the uninsured is worthy only for short term use. As the patient likely would not be able to afford the brand agent due to high cost, the patient would be best served for chronic issues by using generics. Clearly, from the pharm point of view the uninsured is not a valuable customer as there is no means for payment for the drug resulting in a profit contribution to the manufacturer. Wal-Mart, CVS, Rite-aid and other all have “generic program” that charge the patient a meager $4-10 for a 30-90 day supply. As I am a managed Medicaid pharmacy director, with only a $1 co payment for any branded or generic drug; the essence of the member taking the prescribed drug or even getting it filled is only 70% or less. Medicare part D as are most Medicaid groups are generic first. The economic advantage of generics are good for the patient as well as the plan. It is amazing that the day a branded agent goes generic, the branded drug quits working almost immediately.