A physician survey of the effect of drug sample availability on physicians' behavior

OBJECTIVE: Pharmaceutical companies often use drug samples as a marketing s trategy in the ambulatory care setting. Little is known about how the avail ability of drug samples affects physicians' prescribing practices. Our goal was to assess: (1) under what circumstances and why physicians dispense dr ug samples, (2) if drug samples lead physicians to use medications other th an their preferred drug choice, and (3) the physician characteristics that are associated with drug sample use. DESIGN: Cross-sectional survey. SETTING: University-based clinics at one academic medical center. PARTICIPANTS: 154 general medicine and family physicians. MEASUREMENTS AND MAIN RESULTS: Physicians' self-reported prescribing patter ns for 3 clinical scenarios, including their preferred drug choice, whether they would use a drug sample and subsequently prescribe the sampled medica tion, and the importance of factors involved in the decision to dispense a drug sample. A total of 131 (85%) of 154 physicians responded. When present ed with an insured woman with an uncomplicated lower urinary tract infectio n, 22 (17%) respondents reported that they would dispense a drug sample; 21 (95%) of 22 sample users stated that they would dispense a drug sample tha t differed from their preferred drug choice. For an uninsured man with hype rtension, 35 (27%) respondents reported that they would dispense a drug sam ple; 32 (91%) of 35 sample users indicated that they would dispense a drug sample instead of their preferred drug choice. For an uninsured woman with depression, 108 (82%) respondents reported that they would dispense a drug sample; 53 (49%) of 108 sample users indicated that they would dispense a d rug sample that differed from their preferred drug choice. Avoiding cost to the patient was the most consistent motivator for dispensing a drug sample for all 3 scenarios. For 2 scenarios, residents were more likely to report using drug samples than attendings (P < .05). When respondents who chose a drug sample for 2 or 3 scenarios were compared to those who never chose to use a drug sample, or chose a drug sample for only one scenario, only youn ger age was independently associated with drug sample use. CONCLUSION: In self-reports, the availability of drug samples led physician s to dispense and subsequently prescribe drugs that differ from their prefe rred drug choice. Physicians most often report using drug samples to avoid cost to the patient.