In medicine, as in life, there is no such thing as a free lunch.  A new study in JAMA Dermatology shows that “free” samples of prescription skin products aren’t free at all.  In fact, patients who were given free samples along with a prescription from their dermatologist paid more than twice as much out-of-pocket to fill those prescriptions than those who were not given free samples. The reason, says Karen Kaplan, is that the ability to hand out free patient samples appears to influence dermatologists’ prescribing habits:

In 2010, nine of the 10 most popular acne drugs nationwide were either brand-name drugs or branded generics (which companies sell at a premium), and free samples for them are typically available. To get a sense of whether things would be different in the absence of free samples, the researchers examined the prescribing behavior of dermatologists at an academic medical center that had a policy against freebies. In this group, nine of the 10 most popular acne drugs were low-cost generics (which don’t come with free samples).


In other words, doctors who can give samples of expensive, brand name medications go on to prescribe it, while doctors who don’t have free samples to give to their patients tend to prescribe (significantly) less expensive generic medications.

This phenomenon isn’t isolated to dermatologists.  In fact, more and more hospitals, medical clinics, and private medical offices discourage, if not forbid, pharmaceutical reps — and their free samples — from entering their drug closets.  Kaplan quotes from the accompanying editorial, showing just how much things have changed in a few short years:

“Alongside those other inappropriate tools of drug marketing – sports tickets, Caribbean junkets, and free pens – samples belong not in dermatologists’ closets, but in our dustbins.”