Medicare beneficiaries and free prescription drug samples: A national survey

被引：23

作者：

Tjia, Jennifer ^{[1
,2
]}

Briesacher, Becky A. ^{[1
,2
]}

Soumerai, Stephen B. ^{[3
,4
]}

Pierre-Jacques, Marsha ^{[3
,4
]}

Zhang, Fang ^{[3
,4
]}

Ross-Degnan, Dennis ^{[3
,4
]}

Gurwitz, Jerry H. ^{[1
,2
]}

机构：

[1] Univ Massachusetts, Sch Med, Div Geriatr Med, Worcester, MA 01605 USA

[2] Fallon Clin Fdn, Meyers Primary Care Inst, Worcester, MA USA

[3] Harvard Univ, Sch Med, Dept Ambulatory Care & Prevent, Boston, MA 02115 USA

[4] Harvard Pilgrim Hlth Care, Worcester, MA USA

来源：

JOURNAL OF GENERAL INTERNAL MEDICINE | 2008年 / 23卷 / 06期

关键词：

free samples; pharmaceutical companies; Medicare;

D O I：

10.1007/s11606-008-0568-2

中图分类号：

R19 [保健组织与事业（卫生事业管理）];

学科分类号：

摘要：

BACKGROUND: New policies regulating physician/pharmaceutical company relationships propose to eliminate access to free prescription drug samples. Little is known about the prevalence of patient activity in requesting or receiving free prescription drug samples, or the characteristics of patients who access drug samples. OBJECTIVE: To determine the prevalence of free sample access and to examine demographic, clinical, and insurance characteristics of Medicare beneficiaries who access free samples. DESIGN: Cross-sectional study. PARTICIPANTS: A national sample of 13,847 Medicare beneficiaries participating in the fall 2004 Medicare Current Beneficiary Survey. MEASUREMENTS AND MAIN RESULTS: Prevalence of free prescription drug sample access (self-reported request for or receipt of free drug samples) and the demographic, clinical, and insurance characteristics of Medicare beneficiaries who accessed drug samples. Overall, 48.3% (95% confidence of interval [CI]: 46.6%, 49.9%) of Medicare beneficiaries reported accessing free drug samples. Access was higher among beneficiaries reporting cost-related medication nonadherence compared to those without (77.7% (95% CI: 74.5%, 80.6%) vs 43.0% (95% CI: 41.4%, 44.7%)). Multivariable analysis revealed cost-related medication nonadherence (CRN) to have the strongest relationship with accessing drug samples (adjusted odds ratio [AOR] 4.43 [95% CI: 3.64, 5.39]). Compared to beneficiaries with generous drug benefits from Medicaid, beneficiaries who lacked prescription drug benefits were more likely to access drug samples (AOR 2.42 [95% CI: 2.06, 2.85]). Beneficiaries with drug coverage from employer-sponsored plans or partial coverage (Medicare HMO, self-purchased Medicare supplement, or state-sponsored low-income plans) were also more likely to access drug samples (AOR 2.02, 1.74, respectively). Having 2-3 or >= 4 comorbidities (vs 0-1 comorbidities) also increased the likelihood of accessing drug samples (AOR 1.60 (95% CI: 1.44, 1.79) and 2.00 (95% CI: 1.74, 2.29). CONCLUSIONS: Accessing free prescription drug samples is prevalent among many categories of beneficiaries, especially among individuals with cost-related medication nonadherence and poor health status. Policies restricting or prohibiting drug sample distribution may adversely impact access to medications among patients in high-risk groups.

引用

页码：709 / 714

页数：6

共 32 条

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