NCPA - National Center for Policy Analysis


August 25, 2004

With prescription drug prices rising, a small but growing number of health systems are dramatically cutting back on their use of free drug samples. They argue that consumers who refill prescriptions for brand-name pills may spend hundreds of dollars more than if they started off with cheaper generics. However, some physicians often reserve samples for patients who can't afford prescription drugs.

Some health companies have tried to soften the blow of banning samples by hiring specialists to help poor patients enroll in discount-drug programs. California-based Kaiser Permanente pioneered such changes more than a decade ago. In the past year and a half, a number of health systems have followed its example:

  • Minnesota's HealthPartners has reduced sample use by nearly 90 percent in the past seven months.
  • Seattle's Group Health Cooperative and Pennsylvania's Geisinger Health System have banned samples and allow drug reps by appointment only.
  • The University of Michigan Health System employs pharmacists to track doctors' prescribing patterns and sometimes suggests more cost-effective treatments.
  • New York state's Excellus BlueCross BlueShield uses pharmacy consultants to update doctors on new drugs so that health professionals don't have to rely on industry reps.

Some health systems have seen dramatic results. Drug costs declined 10 percent after the Seattle-area Everett Clinic banned sales reps and samples in 1998, even as costs rose 15 percent at competing practices, says medical director Al Fisk.

Source: Liz Szabo, "Health care cutting costs by closing door on drug reps," USA Today, August 25, 2004.

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