A small but growing number of hospitals, clinics and other health-care organizations across the country are banning free samples of brand name prescription drugs -- or limiting which samples their doctors can accept from pharmaceutical companies. Even hospitals that serve many uninsured patients who could benefit from the samples are limiting their use.

Doctors have long used free samples to let patients try new treatments, start them on medications quickly or provide free treatment for low income patients.

Ironically, the new policy seems to be based on fears the samples are helping to inflate drug costs. Health-care administrators contend drug companies mainly give out samples of the newest brand name drugs -- which are the most expensive. If the sample works for the patient, doctors will often prescribe the higher-cost drug.

• Last year, drug companies gave doctors free pills worth more than $7.2 billion at retail -- nearly 10 percent more than the year before.

• The value of free samples jumped another 8.4 percent in the first half of this year, compared with the comparable period a year earlier.

• By contrast, the companies only spent $1.8 billion on consumer advertisements.

• Many hospitals that are limiting samples also say they are concerned they could be cited for not properly controlling the samples by the Joint Commission on Accreditation of Health Care Organizations -- which has increased its emphasis on medicine safety in the past two years.

But many doctors are complaining bitterly about the new policy, saying they often depend upon the samples to help patients who lack insurance and cannot afford the expensive new drugs.

Drug companies argue samples play an essential role in health care by allowing doctors to learn about the benefits of new drugs, while allowing patients to evaluate the benefits of new drugs before spending money on a full prescription.

Source: Melody Petersen, "Growing Opposition to Free Drug Samples," New York Times, November 15, 2000.

For text http://www.nytimes.com/2000/11/15/business
/15SAMP.html