What does “sample free” mean for Sentara Medical Group patients?

We’re talking to Dr. David R. Maizel, President of Sentara Medical Group and Dr. Michael Charles, a Sentara Family Medicine physician about the decision to stop providing sample medications to Sentara Medical Group patients beginning April 1, 2012.

Amy: Let’s be honest, we all like freebies. Dr. Maizel, tell us why Sentara Medical Group made the decision to stop offering sample medications to patients.

Dr. David R. Maizel, President of Sentara Medical Group

Dr. Maizel: The term “free sample” makes it sound free and easy. But with medication samples, free doesn’t equate to free. In fact, free samples cost patients and the healthcare system as a whole more money. There’s more than meets the eye when it comes to those freebies we’ve gotten used to.

Dr. Charles: And a lot of people are surprised to discover that samples are always branded medications, never generic options. Branded medications typically cost much more than their generic alternatives. So providing branded samples kicks off a cycle which can literally cost a patient hundreds more over the course of a year.

Dr. Michael Charles, Sentara Family Medicine physician

Dr. Maizel: Yes, and patients should know that generics have the same intended use and effects as branded drugs. In many cases the benefits, risks and side effects are also better known with generic drugs. But the best news for our patients is that many national chain pharmacies are covering generic prescriptions for as low as $4 a month.

Amy: We’ve heard from patients who want to know how they can “try out” a new medication if we aren’t providing samples.

Dr. Charles: If they’re trying a generic medication, then patients shouldn’t be paying much to try it. If they are trying out a branded medication – and we will in a few cases still need to prescribe a branded medication – then their physician may have a voucher from the pharmaceutical company that they can fill at the pharmacy for a discounted or short-term trial.

Dr. Maizel: Vouchers work a lot like free samples but put the responsibility of storing, tracking and dispensing medications at the pharmacy, which is really where it belongs. These days samples come with tedious documentation – gone are the days when doctors could pull open a desk drawer and hand patients a stack of samples. Offering vouchers instead of samples means more time for physicians to see patients and less time spent on paperwork related to handing out samples.

Amy: We’ve heard concern about patients who may be using samples because they can’t afford to pay for medication. How is that being addressed?

Dr. Maizel: It may be surprising, but studies show that patients who rely on samples tend to be the least compliant with their medications. Patients get busy, run out of samples and before you know it, they’re back at the doctor with complications. Thanks to generics, many common prescription drugs are now very inexpensive, even without insurance. But if a patient can’t afford to take a prescription medication then Sentara Medical Group financial counselors will connect them with pharmaceutical prescription assistance programs.

Dr. Charles: Sometimes even with insurance, we see patients having trouble paying for branded medications. I recently had a patient who stopped taking her diabetes medications because her insurance changed her co-pays on the branded medications she’d been taking. She couldn’t afford the $100 per month per medication that she was suddenly being billed by her insurance company. I converted her to two generic medications and she is now getting them for $10 every three months. Generics help save money and this helps patients stick to their medication regimen.

Amy: Is Sentara Medical Group “breaking ground” with this new policy?

Dr. Charles: Actually, this is a growing national trend that dates back as far as 10 years ago. We’ve seen highly respected medical groups and healthcare organizations like Cleveland Clinic and Mayo Clinic adopting this. It may be new to the Hampton Roads area, but we anticipate this becoming the new normal.

Amy: This policy hit the local news recently. During the story they interviewed a concerned pharmaceutical representative. How do you think this policy change impacts our relationships with pharmaceutical representatives?

Dr. Maizel: We are not changing how our practices interact with pharmaceutical reps. In fact, they are encouraged to work with their reps during non-patient care hours to provide vouchers and to provide the education we’ve always valued when working with them.

Amy: Thank you for taking the time to talk about the medication policy. Is there anything else you’d like to add?

Dr. Maizel: Our providers will be talking to patients as we transition to this new policy on April 1. It’s a great reminder to make sure patients are on generic medications whenever possible. Patients who have questions should talk to their Sentara Medical Group provider. We’re working to make this as smooth a transition as possible.

Dr. Charles: We know some of our providers may need to keep a certain sample on hand, so there’s a system in place for providers to apply for an exception from the Sentara Medical Group Quality Committee. I’m the chair of that committee and welcome any provider questions about this policy as we’re rolling it out. I can be reached by email at mgcharle@sentara.com

Amy Sandoval, Corporate Communication Consultant Sentara Healthcare