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Dermatologists' access to drug samples led to costlier prescriptions for acne, rosacea

Dermatologists with access to free drug samples were more likely than those without access to prescribe more expensive drugs for treating acne vulgaris and rosacea, according to recent national study results.

“Physicians may not be aware of the cost difference between brand-name and generic drugs,” researcher Alfred Lane, MD, emeritus professor of dermatology and pediatrics at Stanford University School of Medicine, said in a press release. “And, patients might not realize that, by accepting samples, they could be unintentionally channeled into subsequently receiving a prescription for a more expensive medication.”

Michael P. Hurley, MS, medical student at Stanford University, and colleagues conducted a cross-sectional study of prescribing practices for acne, which the researchers reported is a condition for which free samples are often available. The offices of dermatologists from the National Disease and Therapeutic Index and an academic medical center without samples were researched. Patients who received a prescription from a dermatologist in 2010 for a primary diagnosis of acne vulgaris or rosacea were study participants.

Dermatologists providing samples with a prescription for acne vulgaris and rosacea increased over time at a national level from 10% in 2001 to 25% in 2010. The increase correlated (r=0.92) with “the use of branded generic drugs promoted by these samples.”

Seventy-nine percent of the prescriptions written nationally were branded and branded generic drugs while the academic medical center clinic without samples prescribed 17% of the same drugs. The conservative estimation for the mean total retail cost of prescriptions at an office visit was approximately $465 nationally compared with $200 at the academic medical center without samples.

“The benefits of free samples in dermatology must be weighed against potential negative effects on prescribing behavior and prescription costs,” the researchers concluded.

Disclosure: Researcher Randall S. Stafford, MD, PhD, reported past expert testimony of Mylan Pharmaceuticals, a manufacturer of generic medications, regarding patterns of doxycycline use in treating rosacea.