Wake Forest University Baptist Medical Center

 determined that physicians are less likely to prescribe generic medication if they have equivalent branded drug samples in their sample closet. 

The study examined the prescribing habits of 70 physicians in a large urban practice that moved to a new location in 2000, losing its sample storage area in the process. According to the study, the number of uninsured patients prescribed a generic treatment spiked from 12 percent to 30 percent after access to samples was eliminated, and in subsequent months rose to 40 percent. 

Investigators noted that there was no significant change in generic prescribing patterns for patients on Medicaid (63 percent with samples available, 65 percent without), and explained that fact by assuming that doctors favored the uninsured when handing out samples. 

The study has some limitations. It was performed in a university-affiliated facility using databases from the in-house pharmacy. Patients who filled their prescriptions outside of the location were not included in the data. Nor did the study account for patients who chose not to fill their prescriptions.

“Physicians and medical organizations need to ask themselves if samples are doing more harm than good,” said 

 lead researcher and internal medicine physician at Wake Forest University Baptist Medical Center. “While doctors might intend to help someone by handing them a free sample, in the long run, it could cost them more.” In the study, there was not a significant drop in patient costs when samples were eliminated, but the authors point out that the facility, which serves many low-income patients, was eligible for deep discounts on pharmaceuticals, which may have muted any change.

 that although the study is correct, impoverished and uninsured patients can enroll in a number of patient assistance programs offered by the major pharmaceutical companies. 

“For the most part, tier-two and tier-one companies have programs that are very generous in giving medication for free, and it is very easy to qualify,” Tarnoff said. 

He also noted that with the lack of access to doctors, sales reps are leaving far more samples with each visit. “In many cases-especially in acute cases-doctors will give more than an adequate supply of samples to cover treatment.”

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News Analysis

A new study finds that doctors are three times more likely to prescribe generics when they donâ€™t have access to free samples of branded drugs.

Free Samples and the Bottom Line

 This time, Pfizer has cast an unknown Lipitor user in hopes of avoiding any further scrutiny. The star of the 

 a 58-year-old talent agent from Lafayette, CA, who suffered a heart attack in 2007 and is now taking Pfizer’s cholesterol medication. 

, senior director and team leader for Lipitor, told 

c that Pfizer never considered pulling consumer advertising for the product, and the delay in releasing the new commercial was attributable to creative brainstorming and testing. 

"We believe that DTC is a very effective way to reach people about important medical conditions," he said. "The [last] few months were spent coming up with the most appropriate communications for Lipitor."

 of his celebrity spokesperson duties in February after it came to light that the creator of the mechanical heart wasn’t a licensed cardiologist, and though an MD, had never practiced medicine. 

DTC critics and members of Congress attacked Pfizer for the original Jarvik ad after it came to light that the producers of the spot used a stunt double in shots of Dr. Jarvik performing physical activities. That won’t happen in the Erlendson campaign. "In this commercial, the activities are representative of what John does," Sage said. "He leads an active lifestyle and does exercise with his family, including bike riding, which is what he is doing in the ad. The claims are scripted but the story is true to the detail.

"John, in this case, really resonated with consumers-people that have the condition, because he is like many of them," Sage said. "He was someone who tried to control his cholesterol through diet and exercise, and felt that he could do it on his own. Unfortunately he was unsuccessful, and suffered a heart attack."

There are a few differences between the old Jarvik ads and the new one. Erlendson introduces the commercial with a short story about his past struggle and cuts to a montage of him engaging in physical activities, such as bike riding and walking. 

Sage said that Pfizer is considering casting other patients in the campaign, but for now Erlendson is the face of Lipitor. "John turned out to be an excellent ambassador, and his story really resonated with people," Sage said. "What was really clear when we showed this ad to consumers is that it struck a chord with them to find out more about their condition and speak to their doctors. More than 50 percent of the people who saw it said that they were more likely to speak to their doctor as a result of the ad."

, notes that Pfizer has taken the campaign one step further by adding Joe’s story to the branded site at 

, and filling it with additional information.

"Lipitor did something smart with this campaign," Hilton said. "They took the commercial the extra step and brought it online. And that’s where this campaign comes to life in a real, meaningful way."

Celebrity spokesperson Dr. Jarvik has been replaced with a Regular Joe in the latest Lipitor DTC spots. Will the switch make a difference?

Pharmaceutical Executive-09-10-2008

Free Samples and the Bottom Line

Pfizer Launches New Lipitor Ads