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Healthy Skepticism Library item: 18870

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

 

Publication type: Journal Article

Macdougall C, Udkow T, Guglielmo BJ, Vittinghoff E, Martin J.
National estimates and predictors of prescription medication sample use in the United States, 1999-2005.
J Am Pharm Assoc (2003) 2010 Nov-Dec; 50:(6):677-85
http://www.ncbi.nlm.nih.gov/pubmed/21071311


Abstract:

Objectives: To determine the prevalence of free medication sample use in the United States and analyze the effects of socioeconomic status and drug safety actions.Design: Cross-sectional study.Setting: United States from 1999 to 2005. Participants: Survey respondents representative of the civilian noninstitutionalized population.Intervention: Analysis of data from the Medical Expenditure Panel Survey, a nationally representative longitudinal household survey.Main outcome measures: Identification of a medication as being provided as a sample at least once during a study year.Results: An annual average of 5.1% (range 4.4% in 2005 to 5.8% in 2002) of all prescription medications were provided as a sample at least once during a year, with 18.3% of all Americans who received at least one prescription drug receiving at least one drug as a sample. On multivariate analysis, sample use was greater among young (18-30 years) non-Hispanic whites and the uninsured but had minimal independent association with income. The proportion of sample use among users of hormone replacement therapy and cyclooxygenase-2 inhibitors remained relatively constant even as total use of these drugs declined after Food and Drug Administration regulatory action.Conclusion: Use of medication samples is common in the U.S. population. After adjusting for health insurance, sample use was not associated with income and samples were less frequently provided to racial/ethnic minorities and to the elderly. The putative economic benefits of free samples do not appear to go to patients with the greatest financial need. Drug regulatory actions did not have a disproportionate effect on provision of drugs as samples.

 

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Far too large a section of the treatment of disease is to-day controlled by the big manufacturing pharmacists, who have enslaved us in a plausible pseudo-science...
The blind faith which some men have in medicines illustrates too often the greatest of all human capacities - the capacity for self deception...
Some one will say, Is this all your science has to tell us? Is this the outcome of decades of good clinical work, of patient study of the disease, of anxious trial in such good faith of so many drugs? Give us back the childlike trust of the fathers in antimony and in the lancet rather than this cold nihilism. Not at all! Let us accept the truth, however unpleasant it may be, and with the death rate staring us in the face, let us not be deceived with vain fancies...
we need a stern, iconoclastic spirit which leads, not to nihilism, but to an active skepticism - not the passive skepticism, born of despair, but the active skepticism born of a knowledge that recognizes its limitations and knows full well that only in this attitude of mind can true progress be made.
- William Osler 1909