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PRESCRIPTION DRUG SAMPLING

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Title: PRESCRIPTION DRUG SAMPLING


1
PRESCRIPTION DRUG SAMPLING Is the Status Quo
about to Change?
Kent E. M. Groves BSc, MSc, PhD (Cand) Jason W.
Pendlebury BComm, MBA (Cand)
July 13, 2004
2
We are experiencing a fundamental shift in
prescription samples as a component of the
pharmaceutical marketing mix
Prescription Drug Sampling Is the Status Quo
about to Change?
3
A joint statement by the CMA and the CPA
indicates Physicians and Pharmacists have
complimentary and supportive roles in providing
optimal drug therapy
Canadian Medical Association and the Canadian
Pharmaceutical Association, Can Med Assoc. J,
1996. 155(6) p784A-784C.
Prescription Drug Sampling Is the Status Quo
about to Change?
4
BACKGROUND
  • Prescription or pharmaceutical drug sampling has
    been a key tactic in the pharmaceutical marketing
    industrys attempts to reach the prescribing
    audience of health professionals
  • A number of organizations are looking to offer an
    alternative to this traditional approach to
    prescription drug sampling
  • Success of a new approach to sampling is
    dependent on acceptance and adoption by key
    stakeholders (pharmaceutical manufacturers,
    physicians, pharmacists, policy makers, insurers
    (public and private), regulators and the
    consuming public)

Prescription Drug Sampling Is the Status Quo
about to Change?
5
TRADITIONAL SAMPLING PROS
  • Positive influence on prescribing behavior
  • Provides the opportunity for clinical
    evaluation
  • Immediate provision of a solution for
    patients - relationship
  • Assistance for populations without drug
    insurance
  • Practical experience with new drugs
  • Convenience and immediacy in initiating
    appropriate medication

This is a compiled list of benefits and
shortcomings, and may not be inclusive of
examples that may be unique to individual or
regional situations.
Prescription Drug Sampling Is the Status Quo
about to Change?
6
TRADITIONAL SAMPLING DEFICIENCIES
  • Negative influence on prescribing behavior
  • Risk to patient resulting from lack of 2nd health
    professional involvement
  • Self medication and unregulated use in clinic
    environments
  • Disposal of unused and or expired samples
  • Lack of knowledge of recalls
  • Environmental impact of excessive packaging
  • Cost of pharmaceuticals to the regional
    Pharmacare Program
  • Unregulated handling, delivery and receipt in
    physicians offices

This is a compiled list of benefits and
shortcomings, and may not be inclusive of
examples that may be unique to individual or
regional situations.
Prescription Drug Sampling Is the Status Quo
about to Change?
7
  • Two Main Categories
  • (For our purposes)
  • Traditional Sampling
  • Alternative Sampling

Prescription Drug Sampling Is the Status Quo
about to Change?
8
TRADITIONAL SAMPLING
  • Refers to a form of the drug sampling process
    whereby information about drug samples is
    disseminated using non-technical, conventional
    media (e.g. print advertisements, brochures,
    targeted direct to physician mailing and/or
    personal communication via pharmaceutical
    manufacturers representatives).
  • We also use the term traditional sampling to
    represent the distribution of drug samples
    directly to physicians.

Prescription Drug Sampling Is the Status Quo
about to Change?
9
ALTERNATIVE SAMPLING
  • Refers to the use of technology-based platforms
    to disseminate information about drug samples.
    This technology may include the use of websites,
    e-coupons and vouchers or patient-specific
    databases.
  • Alternative sampling also means that only
    pharmacists have access to drug samples for
    distribution, which eliminates the physical
    involvement with the product by physicians.

Prescription Drug Sampling Is the Status Quo
about to Change?
10
ALTERNATIVE APPROACHES
Prescription Drug Sampling Is the Status Quo
about to Change?
11
TRADITIONAL SAMPLING
Third Party
Physician
Patient
Pharmaceutical Manufacturer
Prescription Drug Sampling Is the Status Quo
about to Change?
12
STATUS QUO
  • Deeply imbedded roots
  • Unwillingness to change
  • Many of the larger pharmaceutical manufacturers
    have the process, systems and infrastructure in
    place to effectively accommodate their existing
    approach to market, and as such would view any
    alternative as both a risk and an unnecessary
    expense

Prescription Drug Sampling Is the Status Quo
about to Change?
13
FULL SERVICE FULFILLMENT SAMPLING
  • This format uses a third party fulfillment house
    to handle the distribution of samples to
    physicians for a companys full range of products
  • Fulfillment sampling markets to physicians
    through brochures, catalogues, web and
    e-promotions, representing a full (or partial)
    line of products from member pharmaceutical
    manufacturers
  • Direct Ordering
  • Housed in a central distribution centre
  • Alliance Healthcare Information, Inc.
  • The Physicians Hotline

Prescription Drug Sampling Is the Status Quo
about to Change?
14
PROFESSIONAL ASSOCIATION PORTALS
  • RxCentric provides online services to physicians
    that include peer-reviewed, objective medical
    information as well as online drug information
    databases, with information provided by facts and
    comparisons with links to relevant sites
  • Ideal platform for integration of sampling with
    online technology
  • Under the administration of (in this case) the
    AMA

Prescription Drug Sampling Is the Status Quo
about to Change?
15
DROP SHIP TRACKING PROGRAM
  • A current sampling technique offered by
    Dispensing Solutions Incorporated uses drop ship
    tracking.
  • DSI, in association with the Pharmaceutical
    Company, packages and labels the samples with the
    predetermined dosage set out by the
    Pharmaceutical Company.
  • The samples are loaded into the DsystemTM and
    drop shipped to the physician.
  • DsystemTM, the hand held wireless device is
    provided to the physicians who are engaged in the
    DSI program.
  • The physician writes a prescription and DsystemTM
    informs them of the inventory available of the
    specified product

Prescription Drug Sampling Is the Status Quo
about to Change?
16
ALTERNATIVE SAMPLING
Third Party
Pharmacist
Patient
Pharmaceutical Manufacturer
Physician
Prescription Drug Sampling Is the Status Quo
about to Change?
17
MULTIPLE MEDIA INTEGRATORS
  • This approach utilizes the strengths of a number
    of traditional media as well as the reach and
    security of both the web and e-communications
  • Organizations pursuing this approach have
    typically been involved in traditional, tactile
    couponing, and have advanced their systems to
    accommodate e-couponing, as well as online usage
    management, tracking and reimbursement to
    pharmacies.
  • MedManage MedSamples E-MedSamples
  • Synavant Value Script

Prescription Drug Sampling Is the Status Quo
about to Change?
18
LOW-TECH TRIAL PRESCRIBING
  • This offering removes the traditional sample and
    the packaging and requires the patient to get
    their samples from community pharmacies
  • Two categories Conventional and Online
  • A voucher or sticker system sees physicians
    removing themselves from the role of dispensing
    drugs and holding supplies on site, while still
    being able to offer patients a way to sample
    recommended drug therapy at no cost
  • Online claim processing also allows a heightened
    degree of sample tracking compared to traditional
    sampling approaches

Prescription Drug Sampling Is the Status Quo
about to Change?
19
PHARMACY DISPENSED SAMPLING
  • This is a program where companies supply
    physicians with certificates for a specified
    drug. These certificates are offered to patients
    along with a prescription for the specified drug
    sample. The prescription is filled as usual by a
    pharmacist who then updates the patients drug
    purchasing profile and who is able to provide
    counselling to the patient
  • The pharmacy records the dispensed sample
    prescription and is reimbursed by the
    pharmaceutical company with either more stock or
    a cash value

Prescription Drug Sampling Is the Status Quo
about to Change?
20
SMART CARD TECHNOLOGY
  • Pre-printed credit cards
  • These cards are signed, authorized and dated by a
    physician and then used by the card-holding
    patients to obtain samples in local pharmacies
  • This credit card technology
    ensures that a trained
    pharmacist,
    in addition to the physician, is
    involved in the medication
    sampling
    process
  • Sampling Technologies Incorporated

Prescription Drug Sampling Is the Status Quo
about to Change?
21
DISCUSSION
  • These alternatives may counter some of the
    shortcomings associated with the existing
    approach to drug sampling, but they face a widely
    accepted, well-entrenched approach that has
    numerous benefits associated with it
  • Non-traditional approaches lend themselves to
    increased communication and linkages between all
    parties involved in the sampling process,
    ultimately moving the system closer to providing
    optimal drug therapy
  • A detailed record of events and observations must
    be maintained in an accessible environment

Prescription Drug Sampling Is the Status Quo
about to Change?
22
CONCLUSION/FUTURE DIRECTIONS
  • More research is needed on the viability and
    effectiveness of various alternative approaches
    of drug sampling in specific populations,
    including the elderly, children, culturally
    diverse groups, and groups with different
    economic backgrounds
  • Changing relationships between pharmaceutical
    manufacturers and individual physicians and
    pharmacists
  • Through education and an increased understanding
    of the convenience, cost effectiveness, improved
    dispersion of knowledge, economies of scale and
    reduction in the handling of potentially harmful
    medication, the stakeholders in the drug
    sampling chain will grow to accept and recognize
    the value and strength of this new model.

Prescription Drug Sampling Is the Status Quo
about to Change?
23
ACKNOWLEDGEMENTS
This work was initiated during a Drug Use and
Management Policy Residency program supported by
CHSRF/CIHR/NSHRF at the Department of
Pharmaceutical Services Nova Scotia Department
of Health under the preceptorship of Dawn Frail.
The opinions are those of the authors and not the
Nova Scotia Department of Health.
Prescription Drug Sampling Is the Status Quo
about to Change?
24
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Prescription Drug Sampling Is the Status Quo
about to Change?
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