By Arthur B. Epstein, OD, FAAO
We often think of drug samples as entitlements to be handed out liberally. But they can be key elements in making our treatment plans more effective–if we present them as something of value.
Most ODs view drug samples as free entitlements. From a drug manufacturer’s perspective, samples are provided to facilitate evaluation of a medication’s effectiveness or to trial a drug or device. In some cases, samples can be used to care for indigent patients who may not be able to afford a needed medication–at least until other arrangements can be made. Since reps typically deliver samples, the cost of distribution can be stunningly high. The cost for each office visit by a rep is around $400 to $600. The main reason why sales reps call is to educate and sample their wares. For drug reps it’s drugs, for contact lens reps it’s to make sure you have enough trials. All of this is very expensive, making sample delivery very expensive.
Some of us view samples as gifts to bestow liberally to curry favor with patients–perhaps because we don’t understand their true value or their power when properly used. Here are some ideas that will help you maximize the benefit of samples. Take drug samples seriously–and use them when you can improve the treatment plan.
Communicate Value of Samples
Accept the fact that samples are not free nor should they be treated trivially. That goes for medications as well as contact lenses and lens care product samples. Treating samples as free gifts devalues them and devalues you as a health care provider.
Don’t lose sight of the communications opportunity afforded by samples. Handing a patient a sample or, worse yet, having your technician do it, says nothing. Using the sample to initiate dialog with the patient can showcase your knowledge and caring. It also ascribes value to the sample–something we often overlook. Handing out “free” trial lenses without a thorough explanation tells the patient the lenses and your care is of little value.
Practice Selective Use of Samples
You can use a sample in an emergency such as a serious condition when the patient has no access to a pharmacy and cannot fill an Rx in a timely fashion. Do not use samples to routinely treat conditions in patients who can afford medications or have coverage. Doing so only increases the cost of care for everyone by raising drug or device prices. Someone has to pay for those “free samples.” Liberal sampling also diminishes the patient’s perception of your clinical acumen and prescriptive authority. Patients perceive things that cost nothing as having little value. How many give out free lens care solution samples at every visit destroying the sample’s perceived value and then wonder why their patients buy bargain basement no-name solutions despite their admonitions to the contrary?
Try Samples Yourself If Possible
One thing I strongly recommend is that you go to your sample cabinet and try every sample in your own eye. Being able to share your first-hand experience with a patient has tremendous power. While individual response to different drugs and devices can be highly variable, the knowledge you can impart is extremely authoritative and validating, especially when your patient experiences a less than pleasant response to a medication that you proactively cautioned them about.
Read Sample Inserts
One final recommendation is that you take the time to read the drug’s or device’s package insert. Not only is this medico-legally responsible and prudent, but it also provides usage and dosing information as well as insight into possible interactions, risks and adverse reactions to a medication such as taste perversion that may occur with azelastine and bepotastine drops.
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Arthur B. Epstein, OD, FAAO, is a contributing editor of Review of Optometry, executive editor of Review of Cornea & Contact Lenses, and chief medical editor of Optometric Physician. He is a partner in North Shore Contact Lens & Vision Consultants in Roslyn Heights, NY. To contact him: arteptstein@artepstein.com.
