摘要：Objectives. Free prescription drug samples are used widely in the United States. We sought to examine characteristics of free drug sample recipients nationwide. Methods. We analyzed data on 32681 US residents from the 2003 Medical Expenditure Panel Survey (MEPS), a nationally representative survey. Results. In 2003, 12% of Americans received at least 1 free sample. A higher proportion of persons who had continuous health insurance received a free sample (12.9%) than did persons who were uninsured for part or all of the year (9.9%; P <.001). The poorest third of respondents were less likely to receive free samples than were those with incomes at 400% of the federal poverty level or higher. After we controlled for demographic factors, we found that neither insurance status nor income were predictors of the receipt of drug samples. Persons who were uninsured all or part of the year were no more likely to receive free samples (odds ratio [OR]=0.98; 95% confidence interval [CI]=0.087, 1.11) than those who were continuously insured. Conclusions. Poor and uninsured Americans are less likely than wealthy or insured Americans to receive free drug samples. Our findings suggest that free drug samples serve as a marketing tool, not as a safety net. Free prescription drug samples are used widely in the United States. The retail value of drug samples distributed in the United States totaled more than $4.9 billion in 1996 and climbed to over $16.4 billion in 2004. 1 – 3 Controversy surrounds the use of free samples. 4 Studies have described potential safety problems, 5 , 6 health professionals who divert samples for self-administration or resale, 7 – 10 the influence of pharmaceutical representatives who distribute samples, 11 – 13 and the contribution of samples to rising drug and health insurance costs. 14 – 16 In addition, numerous studies suggest that free samples may influence the prescribing behavior of physicians and trainees. 7 , 14 , 16 – 22 In its most recent report, the Institute of Medicine has called for further investigation of sample use, citing concerns over patient safety, provider prescribing habits, and consumer adherence to prescribed regimens. 23 Nonetheless, many physicians believe that samples allow them to give free medications to their neediest patients. 10 , 15 This view is also held by the Pharmaceutical Research and Manufacturers of America, whose vice president wrote in the New York Times, “many uninsured and low-income patients benefit from these free samples, which often serve as a safety net.” 24 However, few data are available on recipients of free samples. Although a few studies have looked at the receipt of free samples in selected populations, 6 , 25 , 26 no national study has examined this issue. We analyzed the receipt of free samples using nationally representative data from the United States in 2003 to determine the characteristics of free sample recipients.
