Have you ever received a sample of a medication from your doctor?
Medication samples are provided to physicians by drug companies. Physicians can then choose to provide these samples “free” of charge to their patients for a small duration, in order to determine if the patient tolerates the medication before they receive a prescription for a larger quantity and must pay for the medication themselves. This sounds like a great program at first glance, but there are many built in problems when physicians provide free samples to their patients. Lets take a closer look.
Here is a real life example, showing how and why samples given to patients by physicians can be dangerous.
One of our patients went in for a regular specialist visit. The specialist decided that the patient may benefit from a new medication that has come onto the market and provided the patient with a 1 month sample along with a prescription for the new medication to take to the pharmacy once the sample was complete. The patient then went home and started taking the sample from the doctor as directed. After about 2 weeks the patient started to feel “off”, with symptoms including a new tremor, confusion, sweating and shivering, but didn’t know what was causing the symptoms. The patient then decided to bring the new prescription to our pharmacy to put on file so as not to have to worry about losing the prescription. One of our pharmacists received the prescription from this patient and realized that this new medication was contraindicated for this patient due to a very severe interaction with one of the patients other medications. The symptoms that the patient was experiencing were related to a potentially life threatening drug interaction between the sample that the patient received and another medication the patient was already taking. Thankfully, the patient came into the pharmacy before the interaction became life-threatening in this case. Our pharmacist immediately advised the patient to STOP taking the new sample medication and notified the doctor of the incident. The patients symptoms gradually disappeared after stopping the offending agent.
Here are the major problems that exist with physician providing medication samples:
- The pharmacist is not part of the equation. Meaning no pharmacist will check if the new medication is safe for the patient or if it interacts with any of the patients current medications (including over-the-counter supplements and vitamins). Additionally, when a patient receives a sample medication from the doctor, they are rarely counseled on the efficacy and the potential side effects of the medication as this is the pharmacists role. This presents a safety risk for the patient.
- Samples raise healthcare costs by promoting the the use of expensive products. Samples are generally for the newest medications on the market, therefore the most expensive. Drug companies provide the new and expensive medications as samples to doctors in hopes that patients will end up taking them long term. Expensive samples are started, even when a cheaper and equally effective alternative is available. This increases healthcare costs for both the government (when it a government sponsored plan is involved) and the patient.
- The sample medication may not be covered. In many cases the patient takes the sample for a month, then when they need more they find out they can’t afford the medication and must then be switched to a medication that is covered. This creates unnecessary switching of medications, and can lead to detrimental effects to the patient’s care.