Maybe nothing lasts forever
not the mountains or the sea
but the times we had together
they will always be with me
- The Samples “Nothing Lasts For Long”
The New York Times has a story today about a handful of leading academic medical centers and physician practices restricting or eliminating drug samples. While the drug industry--or more specifically, the drug industry information providers IMS and Verispan--yesterday prevailed in its quest to overturn New Hampshire law forbidding gathering of physician prescription data there, knowing which docs prescribe which drugs and how often will be of less use if reps can't drop in and drop off drug samples.
This isn't necessarily news: the University of Michigan Health System has banned drug samples since 2002. The upshot? Docs and students there practice "without the influence of drug samples, encouraging them to prescribe higher cost brand name medications when a generic or lower cost brand would work as well." But sampling proponents contend that (among other benefits), freebies can be helpful for patients concerned about costs--after all, a free drug costs less than a drug that's, well, not free.
And a new Booz Allen survey published in IN VIVO shows that it's not just the poorest patients who are affected. As more consumers take on much bigger shares of the health costs, say the consultants, they've started to focus on price, including the price of drugs--often going so far as to reject their doctors' recommendations to save money.
So, sampling is good? Maybe, in some cases. But in general sampling is designed to make money for pharmaceutical companies over the long haul, whether or not it saves patients a few bucks at the outset of treatment. Sadly, there's no such thing as a free drug, most of the time.
Despite a few locked cabinets here and there, drug sampling isn't going away quite yet. But these sampling skirmishes are another issue for primary care drug marketers to worry about. Another reason why the appeal of specialty drugs continues to grow.
Are Drug Reps Really Necessary?
ReplyDeleteOne of the main functions of pharmaceutical representatives is to provide free samples to doctor’s offices presently instead of authentic persuasion, and these samples in themselves cost billions to the pharmaceutical industry. Yet arguably, samples are the most influential tool in influencing the prescribing habit of a health care provider. Let me be clear on that point: Its samples, not a representative, who may be the top influencer of prescribing habits.
Yet considering that drug promotion cost overall is approaching 20 billion a year, combined with about 5 billion spent on drug reps themselves, what if there is another way for doctors to get free drug samples, which is what they desire for their patients to initiate various treatment regimens? What if prescribers could with great elation avoid drug reps entirely?
There is, actually, a way to do this, but it is limited. With some select, smaller pharma companies, doctors have the ability to order samples by printing order forms on line for certain medications through certain web sites associated with the manufacturers of these samples. Some examples are such medications that can be ordered in this way are keflex, extendryl, and allerx. Possibly several more can or are available to prescribers in this way. Others, however, cannot be acquired by this method.
So in some situations, a doctor can go on line, print off a sample order form, fax it into a designated fax number after completion of the form, and the samples are shipped directly to the doctor’s office with some products thanks to their manufacturers who provide this avenue. There is no review of the doctors’ prescribing habits by the drug rep. And no embellishments stated by reps actually sounds pretty good for any medical community.
Usually, this system is available for those smaller companies with very small sales forces to compensate for what may be vacant territories, but can be applied to any pharmaceutical company who, upon discretion, could implement such a system.
Now, why is this not done more often? Apparently, it is legal to obtain samples in this manner. If samples are the number one influencer of prescribing habits, why spend all the money on reps to deliver samples personally? It’s worth exploring, possibly, since the drug rep profession has evolved into those who become UPS in a nice suit.
Think of the money that could be saved if more pharma companies offered samples to doctors in this manner. Furthermore, additional benefits with this ideal system are that there is no interruption of the doctor’s practice. And again, there is no risk of bias presented to the doctor by a rep, as they would avoid contact with reps if they order samples through this way- to have the samples directly to be shipped to their office.
When samples are shipped to doctors’ offices in this manner, prescribing information of the particular med is included with the samples shipped. Doctors can order and utilize samples according to their discretion, and would be free of interference from the marketing elements of pharmaceutical corporations. Patients benefit when this occurs.
Considering the high costs associated with the pharmaceutical industry, having samples shipped directly to doctor’s offices should be utilized more than it is presently- regardless of the size of the pharmaceutical company.
Something to think about as one ponders cost savings regarding this issue.
“The new source of power is not money in the hands of a few but information in the hands of many.”
---- John Naisbitt
Dan Abshear
Author’s note: What has been written has been based upon information and belief.