A patient given a free sample of a prescription medication by their doctor may consider it a good deal, but the samples may be leading doctors to prescribe a more expensive drug than is necessary, a U.S. study found.

In a study focusing on dermatologists, researchers at Stanford University's School of Medicine say those doctors given free samples to dispense to patients are more likely to write prescriptions for those expensive drugs than physicians without access to samples are prescribing.

The average retail-level price of the medications prescribed by dermatologists who have access to free samples was around about twice that of those issued by dermatologists working at a university medical center where accepting such samples is prohibited, the researchers reported.

The findings bear on the ongoing debate centering on free samples and whether they are a benefit to patients or likely to affect the prescription inclinations of doctors, leading them to favor brand name varieties of drugs with higher costs for both patients and health insurers.

"Physicians may not be aware of the cost difference between brand-name and generic drugs," says Alfred Lane, professor of pediatrics and dermatology at Stanford, "and patients may not realize that, by accepting samples, they could be unintentionally channeled into subsequently receiving a prescription for a more expensive medication."

Lane is senior author of a study published in the journal JAMA Dermatology.

While branded drugs, which are held under a patent by a particular drug company, represented 79 percent of the prescriptions written nationwide by dermatologists, they were selected only 17 percent of the time in prescriptions issued by doctors working in a university medical center where they are prohibited by policy from accepting free drug samples, the study found.

Lane says that after Stanford Medicine put a policy in place in 2006 prohibiting its doctors from accepting free samples, he noticed a difference between medications he normally chose and those other physicians working in the local community were prescribing.

"I realized that patients were referred to Stanford with prescriptions for newly introduced, branded generics that were unfamiliar to me," Lane says. "Sometimes I had to look up what they actually were. It wasn't clear to me that there was much benefit to these drugs, and they were definitely very expensive."

Previous studies have found around $16 billion in medication samples are given free to doctors by pharmaceutical companies annually.

The accessibility of such samples may result in a doctor being more likely to prescribe an expensive branded drug than explore the option of a less-expensive non-branded generic drug that might be as effective, Lane says.

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