Nearly half of multiphysician primary care practices said in a recent survey they get visited by a pharmaceutical company representative at least once a week, and 60% had closets dedicated to storing free samples.
The findings in the survey from 2017 and 2018 were published in the Journal of the American Medical Association on Monday. Experts question whether the increased frequency of pharma rep meetings and reliance on samples could spur unnecessary costs for patients and healthcare organizations.
“If reducing industry influence on prescribing is a priority, these findings indicate that further measures are needed,” according to the JAMA study.
Researchers got responses from 2,333 primary care practices that ranged from independent multiphysician offices to practices in academic centers and hospital systems. Among all the multiphysician practices, nearly 50% said they get visited every week by a pharmaceutical drug representative, 31% were never visited and 19% got visits a couple of times a year.
The survey also found that nearly 60% of all practices had a closet to store free samples.
The frequency of visits varied based on the type of practice. Independent physician offices with three or more primary care clinicians got the most attention from pharmaceutical companies. The survey found that 60% get visited by a pharmaceutical company every week, and nearly 80% have a sample closet.
Hospitals with at least one primary care practice with multiple physicians weren’t as popular. Only 40% of those surveyed said they got visited every week, and nearly 40% had a sample closet.
The survey also showed that 54% of small practices with fewer than 10 physicians got a weekly visit, and 66% had a sample closet.
But only 27% of large practices with more than 21 physicians got weekly visits and had sample closets.
To be sure, researchers only sampled practices that had three or more primary care physicians, which account for 29% of all U.S. primary care practices. However, larger practices do account for “more than 60% of patients receiving primary care in practice settings,” the study said.
Pharmaceutical manufacturers spend a lot of time going to practices and doling out free samples of brand-name drugs. A 2016 study found that pharma companies spent $18.5 billion on visits and samples, more than any other form of professional marketing. While visits and samples are a popular marketing method, one expert questioned whether the approach will lead to higher healthcare costs and unnecessary prescriptions for patients.
“Both types of promotional spending inevitably increase the overall acquisition cost of a given drug,” wrote Joseph Guglielmo, dean of the School of Pharmacy at the University of California, San Francisco, in an op-ed in JAMA.
Guglielmo said the reliance on samples could lead to preferential prescribing of a brand-name drug over a less-expensive generic. The drugs could also be less safe than other products, he added.
“Although the effects are more difficult to measure, the prescription of medications that are less effective or safe could also lead to increases in physician visits, the use of emergency services, and hospital admissions,” he added.
Guglielmo pointed to a 2009 analysis of 19 studies on pharma rep visits that showed “a consistent association between pharmaceutical promotion and inappropriate prescribing, lower prescribing quality and/or increased prescribing costs.”