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Healthy Skepticism Library item: 18665

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

Pinckney RG, Helminski AS, Kennedy AG, Maclean CD, Hurowitz L, Cote E.
The Effect of Medication Samples on Self-Reported Prescribing Practices: A Statewide, Cross-Sectional Survey.
J Gen Intern Med 2010 Aug 31;
http://www.springerlink.com/content/u34441r650521q05/


Abstract:

BACKGROUND: The pharmaceutical industry spends billions of dollars annually to encourage clinicians to prescribe their medications. Small studies have demonstrated that one of the marketing strategies, the distribution of free sample medications, is associated with increased use of brand name medication over generic medication.nnOBJECTIVES: To determine the relationship between the presence of drug samples in primary care clinics and prescription of preferred drug treatments.nnDESIGN: Cross-sectional survey.nnPARTICIPANTS: Primary care prescribers in the state of Vermont. MAINnnMEASUREMENT: Prescribers were presented with two clinical vignettes and asked to provide the name of the medication they would prescribe in each case. We compared the responses of prescribers with and without samples in their clinics.nnKEY RESULTS: Two hundred six prescribers out of the total population of 631 returned the survey and met the eligibility criteria. Seventy-two percent of prescribers had sample closets in their clinics. Seventy percent of clinicians with samples would prescribe a thiazide diuretic for hypertension compared to 91% in those without samples (P < 0.01). For managing depression 91% of prescribers with samples would have provided a generic medication in a patient with no health insurance, compared to 100% of those without samples in their clinic (P = 0.02).nnCONCLUSIONS: Clinicians with samples in their clinics were less likely to prescribe preferred medications for hypertension and depression.

 

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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