The Journal of the American Board of Family Practice, Vol 15, Issue 5 361-366, Copyright © 2002 by American Board of Family Practice

ARTICLES

Are sample medicines hurting the uninsured?

J. Zweifler, S. Hughes, S. Schafer, B. Garcia, A. Grasser and L. Salazar
University of California, San Francisco-Fresno Medical Education Family Practice Residency Program, Fresno 93702-2907, USA.

BACKGROUND: Pharmaceutical representatives often give sample medications to physicians for distribution to patients. In chronic conditions such as hypertension, this practice can contribute to unnecessary medication changes, gaps in treatment, and inferior control of disease. The objective of the current study was to explore associations between use of free sample medicine, hypertension, and source of payment for health care. METHODS: Telephone interviews and chart reviews were conducted at two community health centers in California. Adults with hypertension who had at least three clinic visits in the previous year and either had no insurance or had Medicare or Medicaid were included. RESULTS: Seventy-one patients participated. Seventeen had received sample medicines up to three times within the previous year. Lack of insurance (P < .01) was associated with sample medicine use. No group differences were found for medication changes. In multiple regression analysis, uninsured patients who received sample medicines had higher diastolic blood pressure (P = .01). CONCLUSIONS: Lack of insurance was the principle predictor of use of sample medications. Although cross-sectional design and covariance of independent variables limit conclusions, higher diastolic blood pressure was related to sample medication use in patients who did not have insurance.