Related Articles The Effect of Medication Samples on Self-Reported Prescribing Practices: A Statewide, Cross-Sectional Survey. J Gen Intern Med. 2010 Aug 31; Authors: Pinckney RG, Helminski AS, Kennedy AG, Maclean CD, Hurowitz L, Cote E 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. OBJECTIVES: To determine the relationship between the presence of drug samples in primary care clinics and prescription of preferred drug treatments. DESIGN: Cross-sectional survey. PARTICIPANTS: Primary care prescribers in the state of Vermont. MAIN MEASUREMENT: 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. KEY 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). CONCLUSIONS: Clinicians with samples in their clinics were less likely to prescribe preferred medications for hypertension and depression. PMID: 20809157 [PubMed - as supplied by publisher]
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Related Articles Saving lives, money and resources: drug and CABG/PCI use after myocardial infarction in a Swedish record-linkage study. Eur J Health Econ. 2010 Apr;11(2):177-84 Authors: Wilhelmsen L, Welin L, Odén A, Björnberg A BACKGROUND: Drug costs are increasing despite the introduction of cheaper generic drugs. The aim of the present study was to analyse the entire costs of hospital care, out-patient care, and the cost of drugs for 16 months following a myocardial infarction (MI) to see to what extent drug costs contribute to the overall costs of care. METHODS: Diagnoses and costs for care as well as mortality data obtained from the Västra Götaland Region, Sweden, and drug costs from the Swedish Board of Health and Welfare, were merged in a computer file. Patients registered from 1 July 2005 to 30 June 2006 were followed from 28 days after an MI, with follow-up until 31 October 2006. RESULTS: Of 4,725 patients, 711 died before the start of the study and 721 during follow-up. Higher age [hazard ratio (HR, 95%CI) = 1.06 (1.05-1.07)], previous MI [HR = 1.31 (1.13-1.53)] and diabetes mellitus [HR = 1.34 (1.13-1.58)] were associated with increased mortality, which decreased with coronary interventions: CABG/PCI [HR = 0.19 (0.14-0.27)]. In a multivariable analysis, mortality was lower for patients taking simvastatin [HR = 0.62 (0.50-0.76)] and clopidogrel [HR = 0.58 (0.46-0.74)]. CONCLUSION: Costs for out-patient care accounted for 25% and drugs for 5% of total costs. If patients not treated with simvastatin or clopidogrel had received these drugs, an additional 154-306 lives might have been saved. Drug costs would be higher, but total costs lower. Thus, even expensive drugs may reduce overall costs. PMID: 19495819 [PubMed - indexed for MEDLINE]
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