Title: PRESCRIPTION DRUG SAMPLING
1PRESCRIPTION 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
2We 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?
3A 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?
4BACKGROUND
- 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?
5TRADITIONAL 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?
6TRADITIONAL 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?
8TRADITIONAL 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?
9ALTERNATIVE 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?
10ALTERNATIVE APPROACHES
Prescription Drug Sampling Is the Status Quo
about to Change?
11TRADITIONAL SAMPLING
Third Party
Physician
Patient
Pharmaceutical Manufacturer
Prescription Drug Sampling Is the Status Quo
about to Change?
12STATUS 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?
13FULL 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?
14PROFESSIONAL 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?
15DROP 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?
16ALTERNATIVE SAMPLING
Third Party
Pharmacist
Patient
Pharmaceutical Manufacturer
Physician
Prescription Drug Sampling Is the Status Quo
about to Change?
17MULTIPLE 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?
18LOW-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?
19PHARMACY 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?
20SMART 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?
21DISCUSSION
- 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?
22CONCLUSION/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?
23ACKNOWLEDGEMENTS
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?
24QUESTIONSCOMMENTS
Prescription Drug Sampling Is the Status Quo
about to Change?