THE practice of using free drug samples to treat some children in the US may be causing more harm than good.
In many countries, doctors are allowed to obtain free samples of new drugs from companies so that they can familiarise themselves and their patients with them. Critics argue that this can divert prescribing away from the best clinical practice.
A team led by Sarah Cutrona of the Cambridge Health Alliance in Massachusetts has now revealed the extent to which free drug samples are given to children in the US. In 2004, 4.9 per cent of the 10,295 children in a nationally representative survey were given at least one free drug sample (Pediatrics, ).
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Among the 15 drugs most frequently distributed were some with safety risks. These include stimulants to treat attention-deficit hyperactivity disorder that the US government lists as controlled substances because of their addictive potential. Also on the list are four drugs that have since been given new or revised 鈥渂lack box鈥� warnings 鈥� labelling indicating safety concerns 鈥� including Elidel, a cream for eczema. Although the cause remains unknown, Elidel received a black box warning in 2006 after some patients developed cancer.
Cutrona is concerned that safety issues often emerge only after drugs are put on the market. 鈥淔ree samples tend to be newer medicines,鈥� she says, so their risks may be poorly understood.
鈥淔ree samples tend to be newer medicines so risks may be poorly understood鈥�
In the US, free drugs are also seen as a means of getting needed medication to people who lack health insurance. Cutrona found that uninsured patients were more likely to receive free drugs when they visited their doctor, indicating that doctors were trying to give the free samples to their neediest patients. But because these patients made fewer visits, they were not more likely to receive free samples than insured children.
