A higher cost to patients

By Kim DeRoche, MD, family medicine, Fairview Northeast Clinic

Our clinic hasn't offered samples for four years. When we had samples, many were high-cost brand names that many insurance companies wouldn't cover. After samples ran out, patients had to pay significant copays to get the medication they needed.

I love the idea of offering generic samples. At Fairview Northeast Clinic, we're considering offering the generic version of drugs doctors prescribe most—like simvastatin, lisinopril or amoxicillin.

Handing out sample brand-name drugs from pharmaceutical representatives is costly to providers and patients in the long run. It increases the cost to the pharmaceutical company, ultimately increasing drug costs.

Some argue that prohibiting pharmaceutical representatives at clinics—like Fairview has chosen to do—shortchanges us because we're missing information. But we have a PharmD in the clinic two days a week, so we can get questions answered objectively, and a robust pharmacy that provides education.

Helping patients with samples can be beneficial. But the costs of brand name samples far outweigh the benefits for patients.

For more information, contact DeRoche, 612-706-4500, kderoch1@fairview.org.

Samples can be worthwhile

By Brent Elert, MD, internal medicine, Fairview Oxboro Clinic

Though inappropriate or overuse of sample medications can be counterproductive, sampling can be useful and improve patient results.

Some patients are wary of taking medications—especially if they or their families have had side effects—and are hesitant to fill a prescription. Some local pharmacies report almost one-third of new prescriptions go unfilled. When physicians provide samples and openly discuss possible side effects and medication interactions, patients are more likely to try medications, thereby improving outcomes.

Samples also are useful when a patient is unable to pay for medication, often due to temporary lack of insurance coverage. Helping that patient with a short supply of medication can make a big difference. Additionally, medication samples may support service recovery with patients who have experienced a long wait or unmet expectations.

Increased cost compared to generics is a major argument against brand samples. But occasionally, name brands are more effective or have fewer side effects than generic equivalents. Sometimes, generics are not available in a certain medication class. In either situation, a brand-name sample trial can help assure effectiveness and tolerability prior to patients paying for a full prescription.

Fairview Oxboro Clinic has been fortunate to provide generic and brand name samples, allowing us to try inexpensive medications prior to more costly name brands.

For more information, contact Elert, 952-885-6118, belert1@fairview.org.