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Sample closet medications are neither novel nor useful
Kari L Evans1, Steven R Brown, Gerald W Smetana
1Department of Family and Community Medicine, University of Arizona College of Medicine, Phoenix, USA.
Summary
Physician-dispensed drug samples often lack novelty and usefulness, despite high costs. This common practice in primary care may not benefit patients and warrants reevaluation.
Area of Science:
- Pharmaceutical Science
- Clinical Pharmacy
- Health Services Research
Background:
- Physicians frequently dispense drug samples in their offices.
- The clinical benefit of this practice for patients is questionable.
- Analysis of commonly stocked sample closet medications in primary care is needed.
Purpose of the Study:
- To evaluate the novelty and usefulness of frequently dispensed drug samples.
- To assess the cost-effectiveness of these medications.
- To inform clinical practice regarding sample medication use.
Main Methods:
- Cross-sectional inventory of 10 sample closets in Phoenix metropolitan area primary care practices.
- Analysis of 23 medications found in at least 7 closets.
- Assessment of novelty (mechanism of action, generic availability) and usefulness (patient-oriented outcomes, safety, tolerability).
- Documentation of 1-month supply costs.
Main Results:
- 96% of samples had a generic equivalent for the same indication; 74% had a generic with the same mechanism.
- Only 13% showed superior patient-oriented outcomes; 26% demonstrated superior safety or tolerability.
- One medication (4%) was guideline-recommended first-line therapy; mean monthly cost was $178.
Conclusions:
- Drug samples in primary care offices possess limited novelty and clinical usefulness.
- These medications are frequently expensive, with high costs for patients.
- The practice of dispensing drug samples requires critical reexamination.
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