Sep 14, 2010

Banning Industry Sales Reps Increases Cost of Every Prescription by $5.18

Medpage Today puts an interesting spin on findings from a study about to be published in the Annals of Family Medicine.  Despite the headline, "Barring Drug Samples Boosts Use of Other Meds", which suggests a straight-forward response -- ban industry and get results -- the study actually tells a very different and more interesting story...

Study Results
After banning sales representatives and medication samples from their clinic, they found:

  • That "aggregate levels of brand-name drug use didn't change significantly"
  • A non-significant trend toward "reduced prescribing of branded anti-hypertensives and lipid-lowering drugs"
  • That "branded drugs for respiratory disease declined significantly, by 11.34%"
  • That "overall cost of prescription drugs were not reduced.  In fact, they increased by $5.18 per prescription per month immediately after the policy was introduced."
They speculate that the increase in overall cost of prescriptions was likely due to the loss of samples in the clinic, but go on to highlight that the cost of "lipid-lowering drugs were significantly reduced, by $0.70, per prescription per month."  It seems that the differential -- $5.18 increase vs. $0.70 decrease -- is sufficient to conclude that the policy hurt patients more than it helped them.

So, in short, the authors of th study found that the policy achieved one thing: It increase cost for patients.  The question that they did not address is "what impact did the policy have on patients?"  How well are the respiratory patients doing following the 11% drop in prescriptions for branded agents.  That's the interesting question given the push towards efficiency and quality moving forward.

Kristina Fiore, Staff Writer. MedPage Today. Barring drug samples boosts use of other meds. September 13, 2010.
Hartung DM, et al "Effect of drug sample removal on prescribing in a family practice clinic"Ann Fam Med 2010; 8: 402-409.

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