"This isn't the way my old doctor treated me," Kevin said as he stood at the nursing station. "He always gave me free samples of my medicine."
Kevin, who has emphysema, high blood pressure and mild heart disease, estimates he spends about $180 a month on medicines. He isn't alone in feeling a bit abandoned, leaving the office without any free samples. But believe it or not, by not giving free samples, doctors are making a good decision based on the patient's best interest.
The way the doctor got the samples in the first place was to agree to sit and listen to a drug salesperson – more often than not, someone with little or no medical training – pitch a new, poorly studied but FDA-approved drug.
In exchange for free samples, a free lunch and perhaps some tickets to a sporting event, the doctor agreed to try the new medicine with his patients.
But those free samples were 99 percent paper, marketing and hype. Packages often contained one or two free pills in a large bottle otherwise stuffed with cotton.
As your parents used to tell you, they weren't really free. Salespeople only provide free samples for new drugs – drugs they are pushing hard.
These pills rarely provide an advantage over older, safer drugs whose effects are better known. So while the first three to five pills of your new prescription seemed free, the cost was recovered in the high prices companies charged for the new prescription. In fact, this type of promotion only serves to raise drug prices.
In many parts of the country, more than 90 percent of doctors still provide free samples, but not here in California. Kaiser was the first to prohibit free samples, and UC Davis and many others now also prohibit their use.
Studies show that without these samples, doctors are three times more likely to prescribe generic drugs. These generics are usually as good, and often better, than the newer drugs being heavily pushed.
In the past couple of years, there have been problems with a number of new medicines, all of which were heavily promoted over cheaper, more effective and safer generic alternatives.
Other studies show that patients who are given free samples end up paying substantially more for medicines than those who are not given free samples.
When drug costs are at an all-time high and people are desperate to make economic ends meet, the last thing we need to do is increase the price people pay for drugs without adding any benefit.
High prices can only lead to more people not filling their prescriptions or skipping doses to save money. It seems clear that these samples do more harm than good by enticing doctors to prescribe expensive medicines that offer no advantage.
Michael Wilkes, M.D., is a professor of medicine at the University of California, Davis. Reach him at drwilkes@sacbee.com.
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