We all love it when we get something free. Cosmetics companies, Costco and even fast-food chains have learned that free stuff creates good will, loyalty and higher satisfaction. Perhaps nobody knows this better than pharmaceutical companies, which have used the "free sample" as a backbone of their $9 billion marketing strategy.
Well-dressed, attractive pharmaceutical sales representatives from the army of 88,000 constantly bounce into doctors' offices across the country, smiling and bringing gifts – and leaving behind free samples of drugs for doctors to give to patients.
Not a bad deal. Or is it?
Americans pay the highest prices in the world for medicines. The identical drug costs a fraction as much in other nations as here. Many drugs are lifesavers, and the huge jump in Americans' life expectancy achieved over the past 100 years was in large part due to medicines, particularly antibiotics.
But a huge part of pharmaceutical companies' budgets goes to promotion and advertising rather than research and development of new drugs. In fact, the majority of drugs developed and tested each year are what I call "me too" drugs – they behave nearly identically to drugs already on the market.
A large part of the drug-promotion budget goes to free drug samples given to doctors – over $15 billion a year worth at the last count. Why do doctors love free samples for their patients? They mistakenly believe they are doing something good for their patients by giving them something for free. They also mistakenly believe these freebies save people money and perhaps even eliminate a trip to the drugstore.
In fact, neither is true.
Who do you think pays for those free samples? Not stockholders or company executives, but sick people who buy drugs. Also, the free samples the doctor gets from the sales reps are not samples of inexpensive drugs or drugs that have been on the market for a long time and are known to be safe and effective. Rather, the samples are of the newest drugs on the block – ones that have limited safety records, are extremely expensive and are usually no better than drugs that cost one-fourth or sometimes one-tenth as much.
The task for drug companies is clear but difficult: Get doctors to turn from prescribing the usual diabetes medicines, blood pressure medicines, antibiotics and antidepressants, and start prescribing the company's new drug. Since few, if any, of these drugs have large benefits over older medications, the best way to motivate doctors is through free samples.
Guess what happens when the few days' worth of free samples given to a patient runs out? Studies show the doctor rarely writes a prescription for the same drug the patient has always used. Instead, since the patient started a new medicine, the doctor continues to use that expensive drug – and it is likely it's not even covered by the patient's insurance company.
So as my mother always told me, nothing is really free. In the case of drug samples, you are almost always better off refusing the free sample and asking your doctor to prescribe a drug that has been around for a while. It may mean a trip to the pharmacy, but you're almost certainly going to end up there either way.
This way, you'll get the best drug for the best price, not the one that drug companies want you to have to boost their profits.
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Michael Wilkes, M.D., is a professor of medicine at the University of California, Davis. Reach him at drwilkes@sacbee.com.
Sunday, January 31, 2010
Inside Medicine: Samples of drugs aren't free - Sacramento Bee
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A large part of the drug promotion budget goes to free drug sample given to doctors over a billions of year worth at the last count.Why do doctors love free sample for their patient? They mistakenly believe they are doing something good for their patients by giving them something for free.They also mistakenly believe these freebies save people money and perhaps even eliminate a trip to the drugstore.
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