Health reform requires disclosure of free drug samples

Here's one more change brought to you by health reform: Those free samples that pharmaceutical companies give to doctors and other health care providers must be disclosed. This is in addition to the new health reform rule that requires health care providers who receive nearly any kind of payment of $10 or more from a pharmaceutical company, medical device maker or other medical industry firm to disclose that fact on a searchable website. The free sample rule, however, is the first to cast light on the extent of a practice long shrouded somewhat in secrecy.

The Wall Street Journal took a look at the preliminary numbers, which are astounding and show just how much of a king drug maker Pfizer is. Thanks to health reform (and the Journal) we now know that Pfizer distributed 101 million drug samples worth $2.7 billion in 2007.  That's almost as much as the next five drug makers combined. According to the Journal, patients and doctors often welcome the free packets of top-selling medicines. But the custom has its critics, who cite safety issues and say samples induce prescriptions for more costly brand-name medicines when cheaper generics might be available. That can actually raise health care costs for some patients, especially the uninsured, who could be forced to pay for brand name drugs when cheaper generics are available.

Drug makers and the health care providers who support the use of free samples say these packages often help doctors and patient evaluate the effectiveness of and a patient's tolerance for a certain drug before a full prescription is given. Some doctors have said that in some cases it can help save patients money because the free samples cut back on the number of drugs a patient may have to pay for themselves, regardless of whether insurance helps cover those costs. That's all well and good. But the health reform disclosure rule doesn't prohibit the use of free samples, it just exposes the practice.

One of the ways health reform is trying to, well, reform health care is by changing the culture of the marketing of medicine. The free sample disclosure rule is one more way to curb some of the excesses that occur in the health care industry. The American Medical Association has supported so-called "sunshine" provisions of health reform. In particular, the AMA supports the health reform requirement of gift disclosure, and has said it will go far toward dispelling perceptions that doctors' health care decisions are influenced by other companies in the industry. Companies that give gifts or pay doctors for their expertise must report the information annually to the Department of Health and Human Services, which then will post it on a website that can be searched by doctor name.

What do you think? Will disclosure dispel the idea that doctors are unduly influenced by the drug industry, or will this health reform rule backfire and cause drug makers to stop giving out samples that can help patients? Let us know your thoughts.

Photo Credit: psyberartist