Free Prescription Samples Increase Rosacea Rx Costs

Written by on April 29, 2014 in prescriptions with 3 Comments
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The existence of free drug samples appears to be altering the habits of doctors such that treatments are overall more expensive for patients.

This is the result of some research into the prescribing patterns of a group of acne and rosacea patients in 2010.

The researchers found that doctors who distributed free drug samples were more likely to prescribe those branded prescriptions rather than a cheaper generic option.

The increased prevalence of branded drugs lead to an overall increase in the price of treatments, as much as double for acne sufferers.

Rosacea Generics

So what might this mean for rosacea sufferers? Well the popular Rosacea Treatments like Metrogel and Oracea do have close molecules that are much cheaper to prescribe.

Would the availability of samples of Metrogel and Oracea lead to doctors more often prescribing these treatments rather than Generic Metronidazole or Generic Doxycycline 50mg a day? This research suggests that this may well be the case.

What is Your Experience?

Have you found that your doctor is keen to write a Rx for a branded treatment, rather than offer a generic?

Were you ever offered a generic alternative to one of the big branded treatments?

More Comments

Some comments from Medscape’s coverage of this article.

Free Dermatological Drug Samples Increase Prescription Costs

Laird Harrison, April 18, 2014

To measure the effects of free samples, the researchers compared data from Stanford University, which does not give out sample drugs, with data from the National Disease and Therapeutic Index, a nationally representative survey of primarily office-based US physicians conducted by IMS Health.

The authors compared branded drugs with generics, as well as branded generics, which they defined as “products that have novel dosage forms of off-patent products or…use a trade name for a molecule that is off patent.”

For acne vulgaris and rosacea, for example, the proportion of prescriptions written from a sample has increased from 10% to 25% during that time. The proportion of branded generic drugs increased in tandem, whereas the proportion of generics remained flat.

The top 5 drugs prescribed for acne vulgaris and rosacea change from year to year, but most years this list is similar to the list of the medications most often prescribed with a sample. Only 1 of the 10 most commonly prescribed acne drugs at Stanford was among the top 10 drugs prescribed nationally.

Article Abstract

Characterizing the Relationship Between Free Drug Samples and Prescription Patterns for Acne Vulgaris and Rosacea

JAMA Dermatol. 2014 Apr 16. Hurley MP, Stafford RS, Lane AT.

Importance Describing the relationship between the availability of free prescription drug samples and dermatologists’ prescribing patterns on a national scale can help inform policy guidelines on the use of free samples in a physician’s office.

Objectives To investigate the relationships between free drug samples and dermatologists’ local and national prescribing patterns and between the availability of free drug samples and prescription costs.

Design, Setting, and Participants Cross-sectional study investigating prescribing practices for acne, a common dermatologic condition for which free samples are often available. The settings were, first, the offices of nationally representative dermatologists from the National Disease and Therapeutic Index (an IMS Health Incorporated database) and, second, an academic medical center clinic without samples. Participants were ambulatory patients who received a prescription from a dermatologist for a primary initial diagnosis of acne vulgaris or rosacea in 2010.

Main Outcomes and Measures National trends in dermatologist prescribing patterns, the degree of correlation between the availability of free samples and the prescribing of brand-name medications, and the mean cost of acne medications prescribed per office visit nationally and at an academic medical center without samples.

Results On a national level, the provision of samples with a prescription by dermatologists has been increasing over time, and this increase is correlated (r = 0.92) with the use of the branded generic drugs promoted by these samples. Branded and branded generic drugs comprised most of the prescriptions written nationally (79%), while they represented only 17% at an academic medical center clinic without samples. Because of the increased use of branded and branded generic drugs, the national mean total retail cost of prescriptions at an office visit for acne was conservatively estimated to be 2 times higher (approximately $465 nationally vs $200 at an academic medical center without samples).

Conclusions and Relevance Free drug samples can alter the prescribing habits of physicians away from the use of less expensive generic medications.

The benefits of free samples in dermatology must be weighed against potential negative effects on prescribing behavior and prescription costs.

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About the Author

About the Author: David Pascoe started the Rosacea Support Group in October 1998. .

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3 Reader Comments

  1. Diane says:

    I never knew there was generics out there. My doctor gave samples, then a prescription. I went to pay and could not afford the prescription so I use nothing and am trying to treat myself through various other products.

  2. David Pascoe says:

    Comment via email.

    “My opinion\experience with prescription drugs -is that they severly damage the liver-and should Not be give to kill a Demodex dust mite/Rosacea……………….”

  3. Maria Oquendo says:

    I just started this medication 2 days ago. will have to see if it works. I have been on doxycycline with positive results. I’m also on Finacea…Lets hope it helps with my most recent flare up.

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