Sample medication dispensing in a residency practice.
BACKGROUND: The distribution of sample medications to physicians by pharmaceutical manufacturers has been regulated by Congress and extensively critiqued in the medical literature. Manufacturers distributed 2.4 billion samples in 1988, yet there are no published reports on the clinical use of sample medications. METHODS: A 4-week descriptive study was conducted that catalogued the contents of a sample medication collection in a family practice residency model office, calculated the value of the sample collection (average wholesale price [AWP]), and monitored dispensing of medication samples. RESULTS: The collection initially contained 5546 samples with an AWP of $19,273. A total of 1012 samples worth $4154 was withdrawn from the collection during the study period. Patients received 548 of the sample packages in 105 dispensements ($2583), physicians or their families received 169 samples in 44 dispensements ($603), others received 26 samples in 6 dispensements ($152), and the destination of 269 samples ($816) was unknown. When a prescription was written at the time that a sample was dispensed, it was almost always for the same brand-name medication. CONCLUSIONS: Although a majority of medications dispensed were given to patients, approximately one third of the value of the medications withdrawn either went to physicians and their families or had an unknown destination. The high association of sample dispensing and simultaneous prescribing of the same brand-name drug supports the contention that sampling influences physician-prescribing habits. Further research should define how the availability of free sample medications affects physician-prescribing practices.