Abstract
Background
The pharmaceutical industry spends billions of dollars annually to encourage clinicians to prescribe their medications. Small studies have demonstrated that one of the marketing strategies, the distribution of free sample medications, is associated with increased use of brand name medication over generic medication.
Objectives
To determine the relationship between the presence of drug samples in primary care clinics and prescription of preferred drug treatments.
Design
Cross-sectional survey.
Participants
Primary care prescribers in the state of Vermont.
Main Measurement
Prescribers were presented with two clinical vignettes and asked to provide the name of the medication they would prescribe in each case. We compared the responses of prescribers with and without samples in their clinics.
Key Results
Two hundred six prescribers out of the total population of 631 returned the survey and met the eligibility criteria. Seventy-two percent of prescribers had sample closets in their clinics. Seventy percent of clinicians with samples would prescribe a thiazide diuretic for hypertension compared to 91% in those without samples (P < 0.01). For managing depression 91% of prescribers with samples would have provided a generic medication in a patient with no health insurance, compared to 100% of those without samples in their clinic (P = 0.02).
Conclusions
Clinicians with samples in their clinics were less likely to prescribe preferred medications for hypertension and depression.
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References
Donohue JM, Cevasco M, Rosenthal MB. A decade of direct-to-consumer advertising of prescription drugs. N Engl J Med. 2007;357:673–81.
Cutrona SL, Woolhandler S, Lasser KE, et al. Characteristics of recipients of free prescription drug samples: a nationally representative analysis. Am J Public Health. 2008;98:284–9.
Tija J, Briesacher BA, Soumerai SB, et al. Medicare beneficiaries and free prescription drug samples: a national survey. J Gen Intern Med.2008;23:709–14.
Henry J. Kaiser Family Foundation. National Survey of Physicians, part II: Doctors and prescription drugs. 2002. Available from http://www.kff.org/rxdrugs/loader.cfm?url=/commonspot/security/getfile.cfm&pageID=13965. Accessed July 25, 2010.
Chew LD, O’Young TS, Hazlet TK, et al. A physicians survey of the effect of drug sample availability on physicians’ behavior. J Gen Intern Med. 2000;15:478–83.
Symm B, Averitt M, Forjuob SN, Preece. Effects of using free sample medications on the prescribing practices of family physicians. J Am Board Fam Med. 2006;19:443–9.
Adair RF, Holmgren. Do drug samples influence resident prescribing behavior? A randomized trial. Am J Med. 2005;118:881–4.
Miller DP, Mansfield RJ, Woods JB, et al. The impact of drug samples on prescribing to the uninsured. South Med J. 2008;101:888–93.
Boltri JM, Gordon ER, Vogel RL. Effect of antihypertensive samples on physician prescribing patterns. Fam Med. 2002;34:729–31.
Brewer D. The effect of drug sampling policies on resident prescribing. Fam Med. 1998;30:482–6.
Chobanian AV, Bakris GL, Black HR, et al. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. JNC 7-complete version. Hypertension. 2003;42:1206–52.
Mann J. The medical management of depression. NEJM. 2005;353:1819–34.
Vittinghoff E, Glidden DV, Shiboski SC. Regression methods in biostatistics: linear, logistic, survival methods, and repeated measures models. New York: Springer; 2007: 19
StataCorp. Stata Statistical Software: release 10. College Station, TX: StataCorp LP; 2007.
Scott AB, Culley EC, O’Donnell J. Effects of a physician office generic drug sampling system on generic dispensing ratios and drug costs in a large managed care organization. J Manag Care Pharm. 2007;13(5):412–9.
Conklin MH, Culley EJ, O’Donell J. Case study of the effects of office-based generic drug sampling on antibiotic drug costs and first-line antibiotic prescribing ratios. J Manag Care Pharm. 2009;15:55–61.
Mukamal KJ, Markson LJ, Flier SR, Calabrese. Restocking the sample closet: results of a trial to alter medication prescribing. J Am Board Fam Pract. 2002;15:285–9.
Shrank WH, Choudhry NK, Solomon DH, et al. Rationale and design of the study assessing the effect of cardiovascular medications provided as low-cost, evidence-based generic samples (Samples) trial. Am Heart J. 2009;157:613–9.
Vermont General Assembly. Act 80: Chapter 91, (2008) Montpelier, Vermont
STFM Group on Pharmaceutical Industry in Family Medicine. Guidelines for residency program relationships with pharmaceutical and other proprietary companies. Kansas, MO: Society of Teachers of Family Medicine; 1994.
Acknowledgements
This project was funded by the Freeman Medical Scholars Program, The Champlain Valley Area Health Education Center, and the Attorney General Consumer and Prescriber Grant Program
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None disclosed.
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This project was funded by the Freeman Medical Scholars Program, The Champlain Valley Area Health Education Center, and the Attorney General Consumer and Prescriber Grant Program
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Pinckney, R.G., Helminski, A.S., Kennedy, A.G. et al. The Effect of Medication Samples on Self-Reported Prescribing Practices: A Statewide, Cross-Sectional Survey. J GEN INTERN MED 26, 40–44 (2011). https://doi.org/10.1007/s11606-010-1483-x
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DOI: https://doi.org/10.1007/s11606-010-1483-x