title: Characterizing the relationship between free drug samples and prescription patterns for acne vulgaris and rosacea.
abstract: OBJECTIVE
  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.
  
  
  OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  METHODS
  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
  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.
authors.affiliation: Department of Health Research and Policy, Stanford University School of Medicine, Stanford, California.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Hurley
authors.affiliation: Stanford Prevention Research Center, Program on Prevention Outcomes and Practices, Stanford University School of Medicine, Stanford, California.
authors.forename: Randall S
authors.initials: RS
authors.lastname: Stafford
authors.affiliation: Department of Dermatology and Pediatrics, Stanford University School of Medicine, Stanford, California.
authors.forename: Alfred T
authors.initials: AT
authors.lastname: Lane
mesh_terms: D000152:Acne Vulgaris / Q000175:diagnosis / Q000188:drug therapy*; D017046:Cost Savings; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D003879:Dermatologic Agents / Q000191:economics / Q000627:therapeutic use; D003880:Dermatology / Q000379:methods; D004345:Drug Industry / Q000191:economics / Q000639:trends*; D004363:Drug Utilization / Q000191:economics / Q000639:trends*; D005260:Female; D006801:Humans; D008297:Male; D040541:Marketing / Q000191:economics / Q000639:trends; D010818:Practice Patterns, Physicians' / Q000191:economics / Q000639:trends*; D055553:Prescription Drugs / Q000008:administration & dosage*; D012393:Rosacea / Q000175:diagnosis / Q000188:drug therapy*; D014481:United States
chemical_list: D003879:Dermatologic Agents; D055553:Prescription Drugs
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