Abstract

Rugmini Warrier*, Michael S. Monaghan, Anna Maio, Kathryn Huggett and Eugene Rich

The purpose of this investigation was to systematically review and assess the influence of the pharmaceutical industry on physician prescribing. MEDLINE, PubMed and WebSPIRS were searched using the following terms: sample closet, drug samples, sample medications, sample medication utilization, sample dispensing, drug sample availability, drug industry, legislation drug samples, drug promotion, prescribing behavior and advertising. Two researchers independently evaluated and abstracted each article and compiled descriptive data. Of the 334 potentially relevant articles screened using the key words, 96 studies were considered for evaluation by reviewers. Of these, 40 studies addressed effects of sample availability on physician prescribing behavior. Access to drug samples influenced prescribing decisions in most of the studies. Physicians were more likely to prescribe heavily advertised drugs when they had access to samples. At the same time, there was a decrease in the prescribing of over-the-counter, generic, and inexpensive drugs. Availability of samples promoted prescribing habits inconsistent with practice guidelines and in conflict with teaching and formulary policies. The reliance on samples tended to prompt the question, “What samples do we have?” rather than, “Which drug is best for the patient?”