It seems silly to suggest that something given to you for free may be too expensive, doesn’t it? But there is an underlying cost to everything in health care, so it’s important to understand the true cost of “free” drug samples your doctor provides.
Closets full of them are stocked by pharmaceutical company representatives — those good looking, well-dressed, computer bag-toting people you sometimes see in the doctor's waiting room. The reps provide samples of their companies’ latest new medications to encourage doctors to prescribe and patients to try them.
Why a “Good” Deal Might Not Be
At first glance, it seems generous; a good way to try before you buy. After all, filling a prescription can be costly. And if you’ve paid for it only to find out that the medication either doesn’t work or has given you a bad reaction, that’s a waste of money.
But here’s the problem: Free drug samples are only available for expensive, branded drugs. “Branded” means the original developer puts its name and logo on them, holds a patent for them and can charge as much as it wants. Doctors are instructed to give their patients only enough of those drugs to get started. Then, they write a prescription that must be filled — and paid for — in order to keep taking them.
Less expensive generic drugs are never available as free samples. That’s because the original developer’s patent is no longer valid and other companies can begin manufacturing them, creating competition. Yet generics contain the same active ingredients, and work in the body in exactly the same way (the government calls this “bioequivalent”); they’re far less expensive because the patent is no longer in effect.
Doing the Math
So let’s do the math: Say your doctor prescribes a branded drug for you to take for the next six months. You check in with your insurer and learn that your co-pay will be $45 a month.
Your doctor gives you the first month’s worth of the prescription for free, saving you $45. But over the next five months, your co-pay will total $225, as long as you keep up the prescription.
But then you learn that there’s a generic version that would cost only $15 a month. Even if you pay for it for all six months, it will run you only $90 to finish your prescription, a savings of $135 over the branded drug.
Which would you rather pay? $225 for five months? Or $90 for six months? Now you can see why that “free” drug is too expensive.
What to Do When Offered a Sample
How can you be sure you’re getting the drug you need for the least amount of money?
When your doctor says she wants to treat you with a prescription drug, start by discussing its pros and cons. If you agree it’s a good idea, ask if there is a generic version. If there is, ask for a prescription for the generic. If there’s no generic, ask your doctor if there is another way to treat your problem that would be less expensive than a branded drug.
In some states, no matter what drug a prescription calls for, if a generic is available, it will automatically be substituted even if the prescription has been written for the branded drug — unless the doctor makes a notation of “DAW” (Dispense as Written) on the prescription.
If you doctor has designated “DAW,” ask her why. Based on your discussion, you can decide if you prefer the generic, knowing it may cost far less.
Even if there is a generic option, your doctor may offer you free samples of the branded version. In that case, ask if it’s possible to take the samples until they run out, so you can then switch to the generic to complete the prescribed course.
Being a smart patient includes being a smart consumer, too.
Trisha Torrey is a patient advocate who works to help improve the relationship between patients and providers. She is the author of You Bet Your Life! The 10 Mistakes Every Patient Makes.