According to a study published today in JAMA Dermatology, branded and branded generic drugs (products that have novel dosage forms of off-patent products or use a trade name for a molecule that is off patent) accounted for 79 percent of the prescriptions written nationally by dermatologists compared with 17 percent at an academic medical center without samples. The average total retail cost of prescriptions at an office visit for acne was estimated to be twice as high ($465) nationally compared with about $200 at an academic medical center without samples.

In a related editorial, Kenneth A. Katz, M.D., M.Sc., of the Permanente Medical Group Inc., Pleasanton, Calif., and colleagues write: “…the demonstrated association between samples and prescribing is strong and is consistent with a growing body of evidence that drug samples affect physician prescribing practices.”

It’s interesting that while the percentage of prescriptions written with samples has decreased over time for other specialists, prescriptions with samples written by dermatologists have increased!

Here’s the chart:

Why is this? The authors of the study conclude:

“While there are many benefits and drawbacks of providing free drug samples, minimizing their use has been advocated by professional organizations and by physician practices. Dermatologists, and physicians more generally, should be aware of how the availability of free samples influences physician prescribing behavior and increases health care expenses. The negative consequences of free drug samples affect clinical practice on a national level, and policies should be in place to properly mitigate their inappropriate influence on prescribing patterns.”

In a survey I conducted some time ago, 72% of respondents agreed “strongly” or “somewhat” to the following statement: “Samples are an essential component of physician marketing and assure market share growth for the drug. That is, without free samples, it is less likely that doctors will prescribe the drug as a first choice” (see more survey results here). I guess this study confirms that opinion.