Pharmacology Book


Medication Cost

Aka: Medication Cost, Pharmaceutical Representative, Drug Rep, Prescribing Cost, Sunshine Act, Drug Cost
  1. Research: Studies
    1. Evaluation of 446 physicians surveyed
      1. Higher Prescribing Cost risks
        1. Pharmaceutical Representative exposure
        2. Group practice setting
      2. References
        1. Caudill (1996) Arch Fam Med 5:201-6 [PubMed]
    2. Direct drug advertising to healthcare consumers
      1. Appears to increase sale of drugs
      2. May result in inappropriate prescribing practices
      3. In 2017, Lyrica marketing cost $216 Million <5% of its over $5 Billion revenue for the year
      4. Mintzes (2002) BMJ 324:278-9 [PubMed]
    3. Pharmaceutical samples raise overall Prescribing Costs
      1. Symm (2006) J Am Board Fam Med 19(5): 443-9 [PubMed]
    4. Poorest patients are the least likely to receive free drug samples
      1. Typical drug sample recipient has health insurance and lives far above poverty line
      2. Cutrona (2008) Am J Public Health 98(2): 284-9 [PubMed]
    5. In 2004, >25% ($16 billion) of drug company advertising ($57 billion) was spent on samples
      1. Gagnon (2008) PLoS Med 5(1): e1 [PubMed]
  2. Background: Legislation
    1. Sunshine Act (U.S. regulation as of August 2013)
      1. Pharmaceutical Representative gifts over $10 are reported to a public list (with the provider's name)
    2. Prescription cost transparency (2019)
      1. New U.S. legislation in 2019 requires drug advertisements to include the wholesale cost of the drug
  3. Resources
    1. No Free Lunch
  4. References
    1. Dachs (2009) Am Fam Physician 79(10): 891-4 [PubMed]

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