Saturday, August 16, 2008

What's Next: Ban Free Drug Samples?

Sometimes, if you want to find the next "crisis issue" that the pharmaceutical industry will face, you don't have to go any further than the industry itself.

Yes, folks, I'm talking about CafePharma!

Recently, I was scouring the CafePharma discussion boards for pharmaceutical sales reps' views on the new PhRMA Code of Interactions with Healthcare Professionals. I found a lot of interesting views on that subject that I will include in an upcoming Pharma Marketing News issue (see the preview here).

But then I came across this post:
Subj: Sign Posted in Doctor's office

This office does not allow visits from pharmaceutical salespeople because we rely on scientific information, not marketing, to decide what treatment is best for you.

This policy also means that we don't provide drug samples.

"Free" drug samples cost you money. Samples are only available for the most expensive, most-promoted drugs, and are a tactic to get you to use drugs that may not be the best therapy for you.
[There were many replies to this post. I won't copy here because I'd like your untainted opinion about the use of drug samples as a promotional tactic by pharmaceutical companies. Please read on and my survey or comment to this post to give me your opinions.]

According to The Prescription Project -- which is funded by the Pew Charitable Trusts and which "seeks to eliminate conflicts of interest created by industry marketing by promoting policy change among academic medical centers, professional medical societies and public and private payers" -- $18 billion a year goes to “free” samples (see "Pharmaceutical Samples"). Other sources confirm that this number is in the right ballpark (see chart, for example, in "Blog Readers' Opinions on Physician Marketing & Education Practices").

While the new PhRMA Code would ban free pens and lunches, it doesn't apply to samples: "It is appropriate," says the Code, "to provide product samples for patient use in accordance with the Prescription Drug Marketing Act."

But the Prescription Project discounts the value to patients of free samples:
Samples encourage physicians and patients to rely on medications that are expensive, but often not more effective than other available drugs. Research has shown that samples can increase physician prescribing of the marketed product, independent of the effect of detailing by industry sales representatives.

Samples serve two distinct marketing purposes. Physicians value samples and are willing to spend time with sales representatives to get them. Secondly, samples serve as “starter” medications – an enticement to prescribe new, heavily marketed and generally more expensive medications. Once therapy has been initiated, patients and their insurers are likely to continue to pay for the new, costly drugs.

Studies indicate that the majority of pharmaceutical samples are not dispensed to low-income or uninsured patients. Nevertheless, many physicians use samples, in part, to provide medications to needy patients. However, the inconsistent availability of samples may limit the utility of this approach.
What's Your Opinion?
Please take a few minutes to respond to the Pharma Marketing News Drug Sampling Survey.

In the meantime, enjoy this sales rep view of sampling (found on CafePharma; sung to the the Eagle's classic "Hotel California"):
Hotel Calipharma

In a dark sample closet, name badge on my coat
when it comes to ambition, I guess I missed the boat.

Up ahead in the hallway, I saw a rep-hating doc.
It was still only 10:00 AM
And I was watching the clock.

There he stood in the hallway
I pulled a detail aid
I was thinking to myself "how can I continue this charade?"
Then he asked for some samples, and I called for a sig
there were nurses down the corridor
I felt like a dumb-ass pig.

Welcome to the Hotel Calipharma
We have lots of lunch
(we have lots of lunch)
for your hungry bunch.
There's plenty of gloom at the Hotel Calipharma
if you're a window witch
(window witch)
we can scratch your itch.

My mind was definitely spinning
Got in my company car
I got a lot of nifty pens and things
but they don't get me too far.

So I called up my DM, and I started to whine
"no success stories today boss,"
"guess your career's in decline."
And still those samples keep coming piled high to the sky
just enough to keep you up all night, still wondering "WHY??"

Welcome to the Hotel Calipharma
Such a dead-end job
(such a dead-end job)
DM's such a slob.

There's plenty of angst at the Hotel Calipharma
Micro-manage you
(micro-manage you)
'till you're worthless too.
We're givin' it up at the Hotel Calipharma
Where the slightest slip
(where the slightest slip)
can result in a PIP [performance improvement plan].

Lots of dumb meetings
Ride-a-longs ain't too nice
and she said, "we are all just corporate bots
"can't get a job in Device."

And in my DM's office
he just sits in his chair.
Doing nothing of value
you know it just ain't fair!

Last thing I remember, I was totally bored.
I had to find an actual job and finally stop driving a Ford.
"Relax" said my DM, we are programmed to deceive.
You can get out any time you like
(I've got some trix up my sleeve!)
And if you need the music to help you sing this song, here's the original soundtrack (open a new window and take the Pharma Marketing News Drug Sampling Survey while you listen):


  1. Anonymous7:44 AM

    The proposal suggested is not a bad idea, with exceptions.

    If this is going to occur, patients need greater access to generic samples, which they do not presently.

    A book called an Orange Book identifies which medications are generic and which ones are not.

  2. Anonymous10:36 AM

    Thanks for the song John.

  3. Anonymous4:25 PM

    I think this would be a tragedy for a lot of consumers and I would think this would be a huge blow to smaller manufacturers who are trying build brand awareness

  4. Anonymous5:54 PM

    My doctor has never given me samples...everytime I visit him, there are at least two reps coming, going, or waiting to be seen. His drug "closet " is more like one of those walk in shoe even has its' own computer! But, alas, there is nothing in there for me...or so he says.
    My last doctor ALWAYS made sure I left with a month's supply (or more ) of samples...of everything I take. I never had to go to the pharmacy when I was seeing him. Unfortunately, they stopped taking my insurance company; it was giving them a hard time with billing, so they decided to drop it. Too bad, because he was a guy who really listened (unlike my current doctor).


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