No more free samples, Wisconsin hospitals tell pharma reps

Sunshine Act, drug costs drive the trend

Many Wisconsin hospitals have stopped distributing no-cost prescription drug samples to patients, saying that the practice was boosting costs and had harmed patient monitoring, the Green Bay Press-Gazette's Richard Ryman reports.

For example, Prevea Health in Ashwaubenon phased out free drug years ago to reduce costs related to tracking the inventory and disposing of expired samples. "When they expire, we have to pay to get rid of them," said Samantha Tonn, a Prevea vice president, adding that managing "inventories with as much safety and security as pharmacies does costs staff time."

Similarly, Fox Cities-based ThedaCare has stopped handing out samples and allowing pharmaceutical visits because physicians at the health system said the practice drove demand for more expensive, brand-name medications, even when they were not the best choice for the patient. The system has also prohibited in-clinic visits from drugmaker representatives.

Mark Hallett, a ThedaCare senior medical director, says that the Affordable Care Act's Physician Payment Sunshine Act was also a factor in the decision to discontinue free samples. The newly enacted law requires medical industry companies to disclose consulting fees, travel reimbursements, research grants, and other gifts that they give to physicians and teaching hospitals.

  • Understanding the Sunshine Act. Here are four PowerPoint slides explaining the basics of the Sunshine Act. Scan them to understand the rules—and inset them directly into your next staff presentation.

At Green Bay's Bellin Health, drug samples have been replaced with vouchers from pharmaceutical companies to establish a better process for helping patients join cost-assistance programs. "Vouchers are easier to control. They don't expire and they don't walk off the shelf," says Amy Dettman, a Bellin vice president.

However, she says the system still allows pharmaceutical representatives to visit physicians because they provide information on new research and new medications. "They are not the only source of information for our physicians," she said, adding that the companies "do sometimes bring experts in."

Pharma responds

Kendra Martello—deputy vice president for trade group PhRMA—says that the industry is keeping a close eye on the trend. "We worry about what it means for patient care and access to safety and treatment information for a certain product," Martello says, adding that samples "serve an important function since they provide immediate feedback on if a medicine works (or) has side effects for that patient" (Ryman, Green Bay Press-Gazette/USA Today, 9/13).

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