Free drug samples hardly help the poor

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If you are poor, uninsured, non-English speaking, or an ethnic or racial minority, you are less likely to receive free drug samples, according to a first of its kind study by Harvard researchers at the Cambridge Health Alliance, published in the February 2008 issue of the American Journal of Public Health. In spite of drug industry claims that free samples act as a “safety net” for the poor and uninsured, the study found that over four-fifths were insured all year and less than a third were low income (under $37,000 for a family of four). Author Sarah Cutrona, Cambridge Health Alliance physician commented:

The distribution of free samples has become very controversial. Evidence shows that free samples may influence physicians’ prescribing behavior and cause safety problems. For instance, we found that the most widely distributed sample in 2002 was Vioxx, with Celebrex being number 3. These drugs turned out to have lethal side effects. While many doctors still view samples as a safety net for their neediest patients, our study shows that samples are potentially dangerous, and do little for the needy.

Senior author Dr. David Himmelstein, Cambridge Health Alliance physician added, “Our findings strongly suggest that free drug samples serve as a marketing tool, not as a safety net.” That’s why some health care networks prohibit the use of drug samples where doctors don’t meet with drug reps.

Potential health risks of marketed drugs have caused some people to think drug sample programs should be illegal. But with the drug industry giving out $16.4 billion dollars worth of free samples in 2004, chances are high that you’ll still receive one or more this year, particularly if you’re insured.

PhRMA’s Senior VP Ken Johnson called the study “fatally flawed,” saying that drug sample distribution “clearly benefits patients and advances healthcare throughout the United States.” This study shows that drug samples mostly reach the insured that have better access to medical care and have a better chance of buying these name-brand prescription drugs.

But who is most in need? A 2005 study shows that uninsured adults are twice as likely as insured adults to say that they or a family member cut pills, did not fill a prescription, or skipped medical treatment in the past year because of cost. High drug costs can put a patient’s health at risk. While they probably help some people, drug samples are like transparent band-aids unable to conceal our broken health care system.