0
Research
National estimates and predictors of prescription medication sample use in the United States, 1999–2005
Conan MacDougall, PharmD, MAS; Tamar Udkow, PharmD; B. Joseph Guglielmo, PharmD; Eric Vittinghoff, PhD; Jeffrey Martin, MD
J Am Pharm Assoc (2003) 2010;50:677-685. doi:10.1331/JAPhA.2010.09086

Abstract

Objectives  To determine the prevalence of free medication sample use in the United States and analyze the effects of socioeconomic status and drug safety actions.

Design  Cross-sectional study.

Setting  United States from 1999 to 2005.

Participants  Survey respondents representative of the civilian noninstitutionalized population.

Intervention  Analysis of data from the Medical Expenditure Panel Survey, a nationally representative longitudinal household survey.

Main outcome measures  Identification of a medication as being provided as a sample at least once during a study year.

Results  An annual average of 5.1% (range 4.4% in 2005 to 5.8% in 2002) of all prescription medications were provided as a sample at least once during a year, with 18.3% of all Americans who received at least one prescription drug receiving at least one drug as a sample. On multivariate analysis, sample use was greater among young (18–30 years) non-Hispanic whites and the uninsured but had minimal independent association with income. The proportion of sample use among users of hormone replacement therapy and cyclooxygenase-2 inhibitors remained relatively constant even as total use of these drugs declined after Food and Drug Administration regulatory action.

Conclusion  Use of medication samples is common in the U.S. population. After adjusting for health insurance, sample use was not associated with income and samples were less frequently provided to racial/ethnic minorities and to the elderly. The putative economic benefits of free samples do not appear to go to patients with the greatest financial need. Drug regulatory actions did not have a disproportionate effect on provision of drugs as samples.

Sign In
APhA Members 
Welcome to JAPhA.org! Please log in below using your APhA username and password. Update your APhA profile.
Not a Subscriber
New to JAPhA? Become an APhA member to receive a full subscription to both the print and online editions.

OR

Register for a FREE limited account to benefit from personalization features such as alerts.

References

Chew LD, O’Young TS, Hazlet TK, et al. A physician survey of the effect of drug sample availability on physicians’ behavior J Gen Intern Med. 2000;15:478–83.[PubMed][CrossRef]
 
Shaughnessy AF, Bucci KK. Drug samples and family practice residents Ann Pharmacother. 1997;31:1296–300.[PubMed]
 
Gibbons RV, Landry FJ, Blouch DL, et al. A comparison of physicians’ and patients’ attitudes toward pharmaceutical industry gifts J Gen Intern Med. 1998;13:151–4.[PubMed]
 
Morgan MA, Dana J, Loewenstein G, et al. Interactions of doctors with the pharmaceutical industry J Med Ethics. 2006;32:559–63.[PubMed]
 
Bultemeier NC. Drug samples In:  Encyclopedia of clinical pharmacy. New York:  M. Dekker;  2003:295–9.
 
Haxby DG, Rodriguez GS, Zechnich AD, et al. Manufacturers’ distribution of drug samples to a family medicine clinic Am J Health Syst Pharm. 1995;52:496–9.[PubMed]
 
Morelli D, Koenigsberg MR. Sample medication dispensing in a residency practice J Fam Pract. 1992;34:42–8.[PubMed]
 
Symm B, Averitt M, Forjuoh SN, Preece C. Effects of using free sample medications on the prescribing practices of family physicians J Am Board Fam Med. 2006;19:443–9.[PubMed]
 
Adair RF, Holmgren LR. Do drug samples influence resident prescribing behavior? A randomized trial Am J Med. 2005;118:881–4.[PubMed]
 
Boltri JM, Gordon ER, Vogel RL. Effect of antihypertensive samples on physician prescribing patterns Fam Med. 2002;34:729–31.[PubMed]
 
Zweifler J, Hughes S, Schafer S, et al. Are sample medicines hurting the uninsured? J Am Board Fam Pract. 2002;15:361–6.[PubMed]
 
Groves KEM, Sketris I, Tett SE. Prescription drug samples: Does this marketing strategy counteract policies for quality use of medicines? J Clin Pharm Ther. 2003;28:259–71.[PubMed]
 
Pertersen M. Growing opposition to free drug samples; ultimate costs and safety are cited. Accessed at www.nytimes.com/2000/11/15/business/growing-opposition-to-free-drug-samples-ultimate-costs-and-safety-are-cited.html, May 15,  2009.
 
Rabin RC. Free drug samples? Bad idea, some say. Accessed at www.nytimes.com/2007/05/01/health/01cons.html, May 15,  2009.
 
Donohue JM, Cevasco M, Rosenthal MB. A decade of direct-to-consumer advertising of prescription drugs N Engl J Med. 2007;357:673–81.[PubMed]
 
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.[PubMed]
 
Tjia 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.[PubMed]
 
Alexander GC, Zhang J, Basu A. Characteristics of patients receiving pharmaceutical samples and association between sample receipt and out-of-pocket prescription costs Med Care. 2008;46:394–402.[PubMed]
 
Cohen SB. Design strategies and innovations in the Medical Expenditure Panel Survey Med Care. 2003;41:5–12.
 
Kneipp SM, Yarandi HN. Complex sampling designs and statistical issues in secondary analysis West J Nurs Res. 2002;24:552–66.[PubMed]
 
 Agency for Healthcare Quality and Research. Definitions of terms used in MEPS-HC questionnaires. Accessed at www.meps.ahrq.gov/mepsweb/survey_comp/hc_quest_terms.pdf, May 15,  2009.
 
 Top 200 brand-name drugs by unit in 2003 Accessed at http://drugtopics.modernmedicine.com/drugtopics/article/articleDetail.jsp?id=104560, May 15,  2009.
 
Hulley S, Grady D, Bush T, et al. Randomized trial of estrogen plus progestin for secondary prevention of coronary heart disease in postmenopausal women JAMA. 1998;280:605–13.[PubMed]
 
Rossouw JE, Anderson GL, Prentice RL, et al. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: Principal results from the Women's Health Initiative randomized controlled trial JAMA. 2002;288:321–33.[PubMed]
 
Hersh AL, Stefanick ML, Stafford RS. National use of postmenopausal hormone therapy: Annual trends and response to recent evidence JAMA. 2004;291:47–53.[PubMed]
 
Haas JS, Kaplan CP, Gerstenberger EP, Kerlikowske K. Changes in the use of postmenopausal hormone therapy after the publication of clinical trial results Ann Intern Med. 2004;140:184–8.[PubMed]
 
Marnett LJ, Kalgutkar AS. Cyclooxygenase 2 inhibitors: Discovery, selectivity and the future Trends Pharmacol Sci. 1999;20:465–9.[PubMed]
 
Bombardier C, Laine L, Reicin A, et al. Comparison of upper gastrointestinal toxicity of rofecoxib and naproxen in patients with rheumatoid arthritis N Engl J Med. 2000;343:1520–8.[PubMed]
 
Bresalier RS, Sandler RS, Quan H, et al. Cardiovascular events associated with rofecoxib in a colorectal adenoma chemoprevention trial N Engl J Med. 2005;352:1092–102.[PubMed]
 
Nussmeier NA, Whelton AA, Brown MT, et al. Complications of the COX-2 inhibitors parecoxib and valdecoxib after cardiac surgery N Engl J Med. 2005;352:1081–91.[PubMed]
 
Solomon SD, McMurray JJ, Pfeffer MA, et al. Cardiovascular risk associated with celecoxib in a clinical trial for colorectal adenoma prevention N Engl J Med. 2005;352:1071–80.[PubMed]
 
Alexander GC, Casalino LP, Meltzer DO. Physician strategies to reduce patients’ out-of-pocket prescription costs Arch Intern Med. 2005;165:633–6.[PubMed]
 
Lurk JT, DeJong DJ, Woods TM, et al. Effects of changes in patient cost sharing and drug sample policies on prescription drug costs and utilization in a safety-net-provider setting Am J Health Syst Pharm. 2004;61:267–72.[PubMed]
 
Freeman HP, Payne R. Racial injustice in health care N Engl J Med. 2000;342:1045–7.[PubMed]
 
Saha S, Freeman M, Toure J, et al. Racial and ethnic disparities in the VA health care system: A systematic review J Gen Intern Med. 2008;23:654–71.[PubMed]
 
van Ryn M, Fu SS. Paved with good intentions: Do public health and human service providers contribute to racial/ethnic disparities in health? Am J Public Health. 2003;93:248–55.[PubMed]
 
Waxman HA. The lessons of Vioxx: Drug safety and sales N Engl J Med. 2005;352:2576–8.[PubMed]
 
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Please read the other comments before you post yours. Comments are moderated and will appear on the site at the discertion of the editorial staff.
* = Required Field
(if multiple authors, separate names by comma)
Example: John Doe



Related Content

Customize your page view by dragging & repositioning the boxes below.

JAPhA Articles
Topic Collections
PubMed Articles
Cardiac safety assays. Curr Opin Pharmacol 2014;15C():16-21.
Advertisement
 
  • Print
  • PDF Download
  • Email
  • Share
  • Get Citation
  • Submit Comment
  • Article Alerts
    Please Wait... Processing your request... Please Wait.
    You must sign in to sign-up for alerts.

    Please confirm that your email address is correct, so you can successfully receive this alert.

  • Letters To Editor
  • Reprints