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Medicare Beneficiaries and Free Prescription Drug Samples: A National Survey

Journal of General Internal Medicine Aims and scope Submit manuscript

ABSTRACT

Background

New policies regulating physician/pharmaceutical company relationships propose to eliminate access to free prescription drug samples. Little is known about the prevalence of patient activity in requesting or receiving free prescription drug samples, or the characteristics of patients who access drug samples.

Objective

To determine the prevalence of free sample access and to examine demographic, clinical, and insurance characteristics of Medicare beneficiaries who access free samples.

Design

Cross-sectional study.

Participants

A national sample of 13,847 Medicare beneficiaries participating in the fall 2004 Medicare Current Beneficiary Survey.

Measurements and Main Results

Prevalence of free prescription drug sample access (self-reported request for or receipt of free drug samples) and the demographic, clinical, and insurance characteristics of Medicare beneficiaries who accessed drug samples. Overall, 48.3% (95% confidence of interval [CI]: 46.6%, 49.9%) of Medicare beneficiaries reported accessing free drug samples. Access was higher among beneficiaries reporting cost-related medication nonadherence compared to those without (77.7% (95% CI: 74.5%, 80.6%) vs 43.0% (95% CI: 41.4%, 44.7%)). Multivariable analysis revealed cost-related medication nonadherence (CRN) to have the strongest relationship with accessing drug samples (adjusted odds ratio [AOR] 4.43 [95% CI: 3.64, 5.39]). Compared to beneficiaries with generous drug benefits from Medicaid, beneficiaries who lacked prescription drug benefits were more likely to access drug samples (AOR 2.42 [95% CI: 2.06, 2.85]). Beneficiaries with drug coverage from employer-sponsored plans or partial coverage (Medicare HMO, self-purchased Medicare supplement, or state-sponsored low-income plans) were also more likely to access drug samples (AOR 2.02, 1.74, respectively). Having 2–3 or ≥4 comorbidities (vs 0–1 comorbidities) also increased the likelihood of accessing drug samples (AOR 1.60 (95% CI: 1.44, 1.79) and 2.00 (95% CI: 1.74, 2.29).

Conclusions

Accessing free prescription drug samples is prevalent among many categories of beneficiaries, especially among individuals with cost-related medication nonadherence and poor health status. Policies restricting or prohibiting drug sample distribution may adversely impact access to medications among patients in high-risk groups.

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Acknowledgments

We acknowledge the contribution of Dana Safran, ScD, without whom, this project would not have been possible.

Funding/support

This study was supported by a grant from the National Institute on Aging to Dr. Soumerai (Grant #R01 AG 022362) and the Harvard Pilgrim Health Care Foundation. Dr. Tjia was supported by a Mentored Clinical Scientist Career Development Award from the National Institute on Aging (Grant #K08 AG021527). Drs. Soumerai, Gurwitz, Ross-Degnan, and Zhang are investigators in the HMO Research Network Center for Education and Research in Therapeutics, supported by the U.S. Agency for Healthcare Research and Quality (Grant #2U18HS010391). Dr. Gurwitz is also supported by a grant under the Attorney General Consumer and Prescriber Education Grant Program.

Conflict of Interest

Dr. Tjia has received financial support from a Pfizer/American Geriatrics Society Junior Faculty Award for Research on Health Outcomes in Geriatrics. Dr. Briesacher has received unrestricted research grants from and served as a consultant for Novartis Pharmaceuticals Corporation within the last 3 years.

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Correspondence to Jennifer Tjia MD, MSCE.

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Tjia, J., Briesacher, B.A., Soumerai, S.B. et al. Medicare Beneficiaries and Free Prescription Drug Samples: A National Survey. J GEN INTERN MED 23, 709–714 (2008). https://doi.org/10.1007/s11606-008-0568-2

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  • DOI: https://doi.org/10.1007/s11606-008-0568-2

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