Collateral Damage: Drug samples under fire

Among 217 US obstetricians and gynecologists surveyed for the study, 92% said getting samples was ethically acceptable, but a third acknowledged that the handouts might influence their drug choice. Participating physicians tended to believe, however, that free samples were likely to have more influence on other doctors than on their own prescribing habits.

According to the study conducted by a research team at the American College of Obstetricians and Gynecologists, drug samples are the fastest-growing form of marketing by drug companies. The value of free samples reached $16 billion, or 63%, of the $25.3 billion the industry spent in the US to market their products in 2003.

Fewer than two-thirds of our respondents indicated that they distributed free samples on the basis of their knowledge of the drug's effectiveness, the study says.

Doctors in the study said they mostly handed out samples based on patients's perceived financial need. Others said they distributed samples because they were available and convenient for patients.

The study's authors recommend discontinuing free samples and other gifts from drug makers.

The only way to exclude bias is to do away with incentive items entirely, because bias remains even when people are taught about bias, the study's authors say.

Drug samples are just the latest focus in the ongoing scrutiny of the industry's marketing practices. Pharmas need to anticipate that marketing reform advocates will eventually get their way and have the practice of providing doctors and patients with free samples prohibited.

The shame is that although the industry will adapt and find other ways to get its product messages out to physicians, patients in financial need will lose one more avenue to access the drugs they need in a system that increasingly fails to meet their needs.

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