Free-Sample Meds Come With Hefty Price Tag
A couple of intriguing theories have emerged following a study into the cost-effectiveness of giving free samples of prescription medications to patients. It seems the free samples are closely linked to some pretty steep out-of-pocket expenses immediately before and after the free samples are dispensed.
Using the Agency for Healthcare Research and Quality’s Medical Expenditure Panel Survey, researchers monitored 5,709 patients from across the nation for as long as two years each. The mean patient age for study participants was 48. Seventy-six percent of the participants were covered with private medical insurance policies and 84% were white. During the study period, 2,343 free samples of medications were handed out.
The study participants’ out-of-pocket expenses varied widely between those who did not receive free samples and those who did. Study participants who did not receive free samples during the course of the study paid an estimated $178 for prescriptions over a six-month period. The average estimated cost associated with the free samples was determined to be $622.
Out-of-pocket expenses for patients who did receive free samples was estimated to be $166 for the six-period before receiving the free samples, another $244 for the six-month time period in which the samples were given, and an additional $212 for the six-month time period after receiving the samples.
Older patients and those using Medicaid as their medical insurance provider were less likely to be offered free samples.
Lead author for the report based on the study, G. Caleb Alexander, MD, a University of Chicago Medical Center’s assistant professor of medicine, suggests caution when dispensing free samples as a means of reducing patient prescription costs. He presents the following scenarios for why the free samples may lead to added expense:
- The medication is often continued as a long-term prescription after the sample medication has been taken. Free samples are most often the newest and most expensive medications available although less expensive medications that have been available for longer may work as well and be more cost effective in the long run.
- Patients receiving samples may have been experiencing underlying health issues which made them more ill initially than those not receiving samples.
Alexander points out that the study was designed to determine only the patient prescription costs associated with free samples, not the reasons why patient cost is higher when samples are received. The research team plans to continue studying the economic impact of prescription medications under various circumstances.
As a result of this study, Alexander urges physicians and patients alike to examine alternative ways to reduce out-of-pocket prescription expenses, such as purchasing a three-month supply instead of a one-month supply, eliminating all prescription treatments that are not essential, and using generic prescription medications more often.
More research is needed, according to Alexander, to explore communications between physician and patient where free samples are concerned, the reasons behind the decision to provide the samples, and the manner in which different physicians, in different types of practice, distribute samples to their patients.
The study was funded by the Robert Wood Johnson Foundation and details will be published in the March 24 issue of Medical Care.
Source: University of Chicago Medical Center
What a surprise.
People with Medicare (“Part D”) or Medicaid were less likely to receive free samples than others. Of course, those with “Part D” who had exhausted their quota of “free” medications and had entered the “doughnut hole” would be paying 100% out of pocket were probably more likely to receive free samples than the “Part D”-ers who were still receiving 100% coverage. 100% out-of-pocket is a lot more expensive than 100% covered. Needless to say, the out of pocket expenses of a group that is enriched in those who do not pay anything for their medications is likely to be lower than the group that is impoverished in those same persons. Everyone knows that physicians are more likely to give their supplies of free samples to those who need to “try before they buy” or who have limited coverage for medication. Furthermore, samples for more expensive medications are in greater demand than for less expensive medications, meaning that both physicians and patients are more motivated to minimize the costs with samples when the care involves a more expensive drug.
(1) People who have to pay for their medications are more likely to seek and receive samples than those who already get them for free or very low cost.
(2) People who do not have to pay for their medications are likely to experience lower out-of-pocket expenses for their medications than those who do.
(3) People who do not need expensive medications are likely to have lower out-of-pocket expenses than those who do need them.
(4) People who require expensive medications are more likely to seek and receive samples than those who do not..
(5) After people who have to pay for their medications develop needs for expensive medications and free samples, they are likely to have greater out-of-pocket expenses than they did before
(6) The need for samples causes the greater out-of-pocket expenses by exactly the same mechanism that carrying umbrellas causes the rain.
Foundations with strong social agendas support bad science to “justify” their agendas.
(7) The New England Journal of Medicine is not the only medical publication more concerned with sensationalism, mass medial coverage, and political correctness than with scientific rigor.
(8) Not every association is causal.
(9) Few people can critically analyze medical research at even the most basic level (Translation: “There’s a sucker born every minute.”).
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