Sample Closet Medications Are Neither Novel Nor Useful

Background: Many physicians dispense drug samples in their offices, but this practice may not benefit patients. We analyzed the novelty and usefulness of the medications most commonly found in sample closets in primary care practices.

Methods: In this cross-sectional study, we inventoried 10 sample closets from internal medicine and family practice offices in the Phoenix metropolitan area. We analyzed 23 medications found in 7 or more closets. To assess novelty, we determined whether the sample medication had a new mechanism of action, a generic version with the same mechanism of action on the market, and a generic medication for the same indication on the market. To assess usefulness, we determined whether the sample medication improved patient-oriented outcomes, safety, and tolerability. We noted the cost of a 1-month supply for a typical starting dose.

Results: Ninety-six percent (n = 22) of sample closet medications had a generic medication for the same indication and 74% (n = 17) had a generic medication with the same mechanism available on the market. Only 3 medications (13%) had evidence of superior patient-oriented outcomes when compared with other medications for the same indication. Six medications (26%) demonstrated superior safety or tolerability. Only one medication (4%) was recommended as a first-line therapy in an evidence-based guideline. The mean cost for a 1-month supply of a typical starting dose was $178.

Conclusions: Sample closet medications have limited novelty and usefulness and are often expensive. The widespread use of sample medications should be reexamined.