Those free drug samples

May 19, 2014 Editorial

Pharmaceutical advertisements on television could leave the watcher nonplussed about what is safe to use especially when confronted by the fine print which admonishes against usage if the prospective consumer is suffering or is likely to be affected by one or more health conditions.
It is usual to read that certain medicines should not be combined with alcohol, or could cause an allergic reaction if mixed with certain other drugs, or can cause drowsiness. People need to know of these risks so as to be able to avoid activities that could cause them harm. Sometimes the only sensible decision might be to not take any of those highly touted over-the-counter drugs, or even those prescribed by a physician. What may be even more worrying is the practice by pharmaceutical conglomerates of making free samples of their products available to the public.
The obvious fact is that most people like freeness, and in low income economies drug samples under this heading are no exception. Of course it is not unusual that the claim would be made that free samples improve patient care, foster appropriate medication use, and help millions of poor patients. All of the foregoing taken in the context that doctors also benefit through their exposure to new treatment options surely makes a convenient argument for the distribution of free samples.
Now is as good a time as any to examine the possible consequences of continued reliance on the availability of free drug samples, and whether they improve access for the poor or promote rational drug usage. The fact of the matter is that drug manufacturers’ representatives are usually trying to promote the newest and most expensive drugs on behalf of their principals. In that light it is a good idea to highlight some disturbing factors which might not be readily apparent in the free drug sample scenario.
A patient can be placed at risk if the doctor has not taken the time to explain the side effects and dosage of sample medication, particularly in instances where no printed instructions accompany the drug. Additionally, in those circumstances, patients being human, might forget the dosage and frequency and might opt to not take the medication out of fear of overdosing. Another consideration is that sometimes patients store unused samples as a backup, but then they return to the doctor with the same complaint and are given a different drug sample to treat their condition and the cycle continues.
The danger here is that the patient is exposed to more than one drug which effectively places them at serious risk of an adverse health reaction. Imagine the impact on the elderly who live alone or have memory problems. Furthermore samples not being generic usually contain the newest agents on the market which may expose patients to risks not yet identified in clinical trials.
If no medical records are kept which show what sample drugs have been given to a patient, there is no way that harmful interactions with other drugs can be monitored. Therefore the patient will most likely not be notified of any recalls for the medication. A cause for concern is the probability that pharmacies which fill prescriptions in this country might not be storing patients’ treatment information in a database.
Depending on the busyness of doctors’ schedules and their relationship to ethical practices, expired drug samples might find their way into patients’ possession. It might be funny if lives were not placed in jeopardy, but a look at the expiration date on samples reveal a relatively short usage time span. Ironically, doctors are still looked up to in the same light of demigods where patients do not question them on the type and purpose of prescribed medications in order to make informed decisions.
On another note, it has been observed that some pharmacies are in the habit of dispensing or selling over-the-counter loose drugs where there is no way of knowing if they are expired or not. Maybe it is time that our local doctors follow in the footsteps of Dr. Nav Persaud and eleven of his colleagues at their family practice clinic in Toronto who voted to end the practice of accepting free drug sample from pharmaceutical company representatives.