Understanding Sample Usage and Sampling as a Promotion Tool: State of Industry Practice and Current Research - Innovation and Marketing in the Pharmaceutical Industry - page 498

for research on pharmaceutical sampling. After that, we review the academic
research as well as industry studies on the effects of samples on pharmaceutical
sales. Lastly, we close the chapter with directions for future research for both prac-
titioners and academic researchers.

17.1 Introduction

In the USA, the practice of dispensing drug samples is one of the most important
tools adopted by the pharmaceutical industry. Industry studies have shown that
sampling as a marketing practice accounts for a signifi cant proportion of company
marketing budgets. Drug sampling is effective in reaching physicians as evidenced
in a survey by Henry J. Kaiser Family Foundation ( 2002 ) which showed that 92 %
of all doctors had accepted drug samples from pharmaceutical sales representatives.
The US pharmaceutical industry delivered an estimated $18.4 billion worth (in
retail value) of free drug samples to doctors in 2005—more than all other marketing
expenses combined (Donohue et al. 2007 ). Therefore, it is important for pharma-
ceutical companies to understand how to distribute most effi ciently these resources
to targeted physicians.
Sampling is claimed to be “the most effective but most expensive way to intro-
duce a new product or to create new excitement for an existing one” (Armstrong
and Kotler 2009 , p. 433). Beyond the pharmaceutical industry, the practice of
distributing free product samples has been adopted by companies in a wide range
of industries such as consumer packaged goods and newspapers (Schultz et al.
1998 ). Compared to sample distribution practices in these other industries, phar-
maceutical sampling is limited because drug samples cannot be legally dispensed
directly from the manufacturers (the pharmaceutical companies) to consumers.
This creates an environment in which doctors have ultimate control over what
drug samples a patient can try. During this process, doctors play a “gatekeeper and
decision maker” role in dispensing the billions of dollars' worth of free samples to
patients. As a result, in order to assess the effectiveness of pharmaceutical sam-
pling it is essential to understand what drives doctors' free sample dispensing
decisions.
Pharmaceutical sampling has become one of the frequently debated topics in
mass media due to the recent increase in public scrutiny regarding the soaring
healthcare cost in the USA (e.g., Rabin 2007 ). In particular, the somewhat unex-
pected fi nding that poor, uninsured Americans are less likely than wealthy, insured
Americans to receive free drug samples in Cutrona et al. ( 2008 ) stirred a heated
public discussion about whether free samples indeed play a “subsidy” role as
claimed by the US pharmaceutical industry and backed up by many doctors. Also,
there is evidence showing that patients receiving free samples had higher out-of-
pocket costs than those who did not, which may lead to discontinuity of treatment,
especially for low-income patients (Chimonas and Kassirer 2009 ). Responding to
these criticisms, some US institutions, such as the University of Michigan Health