Study: Many Drug Samples Go to Higher-Income Patients
Wealthier, insured patients receive no-cost drug samples from physicians more often than lower-income patients, according to a study published on Wednesday in the American Journal of Public Health, USA Today reports.
For the study, Sarah Cutrona, a physician at Cambridge Health Alliance and professor at Harvard Medical School, and colleagues used data from a 2003 Agency for Healthcare Research and Quality survey of nearly 33,000 U.S. residents.
The study found that patients with the highest incomes were the most likely to receive no-cost samples and that 28% of patients who received drug samples had incomes less than 200% of the federal poverty level (Szabo, USA Today, 1/3). Fewer than one-fifth of patients who received drug samples were uninsured at some point during 2003, according to the study (Cooney, Boston Globe, 1/3).The study does not indicate that physicians intentionally give drug samples to patients with higher incomes (USA Today, 1/3).
The survey data show that where people received health care was a significant factor in whether they received no-cost samples. Patients who saw their physicians in offices were more likely to receive samples, and insured patients with better access to care were more likely to see their doctor in an office rather than in an emergency department or hospital clinic.
Cutrona said, "That finding suggests that the samples were a marketing tool and not a safety net because the poor and uninsured patients were not finding their way to where the samples were." She added, "Doctors are trying to target samples to needy patients, but their individual efforts failed to counteract societywide factors that determine access to care."
According to the study, no-cost drugs samples with a retail value of $16.4 billion were given out in 2004, compared with $4.9 billion in 1996. Cutrona said most of the samples were new, high-cost drugs. Cutrona added that no-cost samples also raise patient safety concerns in part because they are not dispensed by pharmacists who check for drug interactions (Boston Globe, 1/3).
Ken Johnson, senior vice president of the Pharmaceutical Research and Manufacturers of America, said studies show that 75% of physicians frequently or sometimes give out drug samples to help patients with out-of-pocket costs (USA Today, 1/3). Johnson in a statement said, "Instead of second guessing motives, Harvard researchers would better serve patients by examining health outcomes," adding, "Clearly, free samples often lead to improved quality of life for millions of Americans, regardless of their income" (Boston Globe, 1/3).
An abstract of the study is available online.
NPR's "All Things Considered" on Wednesday reported on the study. The segment includes comments from Richard Baron, a physician in Philadelphia; Cutrona; and a spokesperson for PhRMA (Silberner, "All Things Considered," NPR, 1/2).
Audio of the segment is available online.