Physicians weigh pros, cons of medication samples

Tom McMahon
http://www.zwire.com

It appears Council Bluffs patients can still receive free medication samples from their physicians.

Physicians at five Creighton Family Healthcare clinics in Omaha recently decided to stop handing them out in most cases, stating the documentation and disposal required make it cumbersome to keep large quantities of free samples. Some other physician groups have also considered doing away with samples.

Dr. David Filipi, vice president of Medical Affairs for Methodist Physicians Clinics, said as far as he knows its Council Bluffs and other Iowa clinics will still dispense the free medication. A few of its Omaha clinics are discontinuing the practice, but each one determines its own policy, he said.

Filipi said that unlike Creighton, the Physician’s Clinics do not have strict documentation requirements. He said their clinics are not required to adhere to strict Joint Commission accreditation standards that apply to hospitals. They must, however, keep track and dispose of expired medications, but that is not an especially cumbersome procedure.

“The Joint Commission is fussier about how they are tracked,” Filipi said. “We apply about 85 percent of their recommendations to our clinics, but we don’t see this one as necessary.”

Dr. Donald Frey, chairman of family medicine at the Creighton University School of Medicine, said his group is generally discontinuing handing out free samples because the documentation required is too time-consuming.

To do it meticulously, he said, the clinics would need to hire two more staffers to track the medications for all five clinics. Their documentation includes recording the number of pills given out; the lot number, in case of a recall; the expiration date and other details.

Frey said a couple of years ago, he served as an expert witness in a court case in which a physician was sued in part because he had not carefully documented a sample that allegedly led to a patient’s adverse reaction. The physician lost the case, Frey said

Aside from the documentation issue, Filipi said free samples might not be that helpful in the long run.

“In the short term, free medications seem like a good thing. But oftentimes they are new, expensive drugs and once the samples are used, the person pays a lot to continue using them.”

He said pharmaceutical companies provide the samples to promote newly patented brands.

“But it’s a hard habit to break.”

Dr. Rocky Fredrickson, of Alegent Health, said each of its southwest Iowa and Nebraska clinics will determine whether to distribute free medication samples. An Alegent Health Clinic committee made that decision last week.

Fredrickson said clinics consider it important for the underinsured to have access to samples, but the downsides are documentation and patients getting used to a medication they may not be able to afford once the samples run out.

Filipi said the free samples can provide some educational benefits to physicians.

“In some practices, it can make doctors aware of newer products on the market.”

But, physicians need to remove any biases that come from using the free products, he said.

The UNMC Physicians, a large group of clinical faculty members at the University of Nebraska Medical Center’s College of Medicine, still distribute samples, said Cory Shaw, the group’s chief administrative officer. UNMC Physicians has 500 doctors who practice at about a dozen locations.

“The documentation issue is not insignificant,” Shaw said.

Nevertheless, the opportunity to give samples to people who are in need financially makes it worthwhile, he said.

A policy statement of the American Academy of Family Physicians in Leawood, Kan., “supports the practice of physicians providing sample medications at no charge to patients based on physician discretion.”

Frey said some Creighton physicians will maintain small quantities of samples for specific patients or purposes. To offset the financial burden on patients, the physicians will prescribe generic drugs or give patients drug company-sponsored vouchers for free drugs that can be used at pharmacies.

-This report contains information from the Midlands News Service

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