How about all those Generic Sampling Programs?

Interesting story in today’s New York Times. Here’s how it begins:

"A new study suggests that free drug samples, an effective marketing tool for the drug industry, do little to help the poor and may put children’s health at risk.”

“… do little to help the poor …”   Really? 

No.  According to the report (published today in Pediatrics), once in a doctor’s office, children who do not have health insurance are more likely to receive free drug samples than children with health insurance. And here's the important context part -- children in the lowest income group were no more likely to receive the samples than were those in the highest income group, in part because the poor are less likely to see doctors.

So how do free samples “do little to help the poor?”  Is there some sort of socio-economic biomarker we need to know about?

Skip to next paragraphBut, “… of greater concern, the authors wrote, are the kinds of drug samples that physicians provide.”  Indeed, the issue of pediatric safety is an important one, but all drugs have risks as well as benefits -- and the Precautionary Principle isn't going to help poor kids get better any faster.  But what it will do is create even wider health disparities.   It's also important to note that the report does not conclude that free samples are causing pediatricians to inappropriately prescribe anything. 

According to the Times, “The study’s lead author, Dr. Sarah L. Cutrona, an instructor at HarvardMedicalSchool, said in an interview that the drugs provided as free samples tended to be the newest, so their safety had often not been thoroughly vetted.”

Hey, what about all those generic sampling progams?

The Times interviewed Dr. Andrew Racine, director of general pediatrics at the Children’s Hospital at Montefiore in the Bronx.  He believes that free samples distort doctors’ decision-making. According to Dr. Racine, “This is just a marketing technique.”

Of course sampling is a marketing technique. But does this make sampling deliterious to pediatric health?  That’s the implication (the headline of the story is "Study says Drug Samples May Endanger Children"). 

"Just" a marketing technique?  What about the therapeutic benefits?

Another pediatrician interviewed by the Times, Dr. Lisa Asta of Walnut Creek, CA, said she's considering banning free samples from her practice because the drugs being promoted generally required high co-payments.

This is another important issue – but the answer is not to provide second class care to one cohort of children and a higher quality of care to another.  And banning samples doesn’t make things better -- it exacerbates the problem.

Click here for the complete story in today’s New York Times.