Biomedical Engineering Reference
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is a signifi cant and positive infl uence of drug sampling on an individual physician's
prescription decisions. The infl uence affects both the physician's base prescription
rate and the physician's responses to detailing. This concept is furthered by
Manchanda et al. ( 2008 ). They found that sampling stock positively affects the
probability of a physician's adoption of a new drug. Finally, Montoya et al. ( 2010 )
use a nonhomogeneous hidden Markov model and fi nd that while detailing may be
more useful as an acquisition tool, sampling is more useful as a retention tool.
The effect of drug samples on prescription decisions is also a topic that is fre-
quently discussed in the medical literature; yet the fi ndings are mixed. Some studies
suggest free samples may cannibalize regular prescriptions in the short term. For
example, Boltri, Gordon, and Vogel (2002) reported that usage of recommended
antihypertensive drugs increased when samples were removed from one clinic. In
another study, Brewer ( 1998 ) found that residents in two programs with restrictions
on samples prescribed more recommended nonsteroidal anti-infl ammatory drugs
(NSAIDS) than residents in a comparable program but without restrictions on sam-
ples. However, other studies suggest the opposite effect that free samples help to
enhance the sales of the promoted drugs. For example, the fi ndings by Symm et al.
( 2006 ) and Adair and Holmgren ( 2005 ) suggest that physicians who distribute free
samples are more likely to prescribe those medications than their counterparts. One
obvious limitation of such studies is that free sample dispensing was the only deter-
minant considered, while a wide range of other factors that would impact a physi-
cian's prescription decision, such as other marketing mix and patient characteristics,
were left out of the studies.
17.4.2
Drivers of Physician's Free Sample Dispensing
Decision
Most research that examines the determinants of a physician's drug sample dispens-
ing decision exists in the medical literature. Two main motives suggested by the
literature are an experimentation role and a subsidy role. The experimentation role
of free drug samples hinges on the belief that free samples are a cost-effective way
for a physician to test for the match between a new drug and a particular patient. The
subsidy role relates to the cost saving to indigent patients through supply of free
drug samples. For example, Chew et al. ( 2000 ) conducted a physician survey to
investigate the purpose of dispensing drug samples. They found avoiding cost to the
patient is the primary reason for dispensing drug samples and evaluating treatment
effectiveness is the secondary reason when the diagnosed condition is complicated.
In addition, Backer et al. ( 2000 ) conducted a fi eld study that found individual physi-
cians vary in their intent when dispensing samples. In particular, physicians use
samples to test for effi cacy, as a temporary relief for convenience of their patients,
or to save cost for their patients.
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