The New York Times ran a story on Wednesday about the pros and cons of doctors distributing prescription drug samples. The article cites the critique (with which we here at PAL are in agreement) that samples are a form of marketing, intended to get physicians to prescribe, and patients to use, the most-expensive and newest drugs (but not necessarily the most effective or the safest).
It is axiomatic that samples are a marketing tool, given the billions that brand-name drug companies spend on them every year — as is true with so much pharma marketing (DTCA, detailing, etc), if drug companies didn’t think there was a financial return, they wouldn’t spend such lavish sums on it.
And in the ubiquity of the sample cabinet in the modern physician’s office lies an opportunity for counter-marketing — the drug sample equivalent of counterdetailing, if you will (or “academic detailing,” as Dr Jerry Avorn, the creator of the concept, calls it). Why not have samples of the most useful, safest, most cost-effective generic drugs in the doctor’s office?
Short answer: There’s no profit in it for generic manufacturers. There’s no way for any given generic manufacturer to ensure that when the patient goes to the pharmacy counter that they will get that manufacturer’s product, as opposed to, say, Teva’s or Mylan’s or any of the dozens of other generic companies’. So a generic manufacturer will not place samples in a doctor’s office when there are numerous competitors producing the same product. (One might justly ask, then, why the generics industry as a whole isn’t collaborating on such an effort — just as one might ask why there’s no generic industry TV ads to counter the “brand-name is better” mythology promoted by every DTCA ad out there — GPHA, what say you?)
Last year, PAL gave one our coveted “Good Guy Awards” to MedVantx, a company that places a “generic sample cabinet” in physicians’ offices. We awarded them the “Real Deal Award: For Promoting Safe, Effective Generics and Countering Drug Industry Marketing.”
MedVantx places an ATM-like machine in doctors’ offices that dispenses 20 of the most common generic medications in a 30-day supply, the typical amount in which a prescription is dispensed. Health insurers contract with MedVantx to place the machines in the offices of doctors in their physicians’ networks. The doctors can use the generic samples for any patient, regardless of what insurance they have, or even if they have no insurance. The savings to a health plan is significant – and to the individual as well, as the 30-day samples are free to the patient. Plus, by increasing the number of generic prescriptions written, the program saves patients money in the long-run as well, given generics’ much lower price tag.
We can only hope that such strategies catch on more and more. With insurers increasingly waiving copayments for generics, and otherwise incentivizing consumers to choose generics, strategies that also encourages doctors to increase their generic prescribing rate are long overdue.