No More Free Drug Samples 英文参考文献.docVIP

Essay NoMoreFreeDrugSamples? SusanChimonas1*,JeromeP.Kassirer2 1CenteronMedicineasaProfession,ColumbiaUniversity,NewYork,NewYork,UnitedStatesofAmerica,2TuftsUniversitySchoolofMedicine,Boston,Massachusetts, UnitedStatesofAmerica Everybody likes something free, and free prescription drug samples are no exception. Patients love to receive them, anddoctorsfeelgoodabouthandingthem out. The practice of providing free drug samples is based on the tacit assumption that ‘‘sampling’’ does much more good than harm.Intwoseparate newsreleases withinthepastyearbythePharmaceutical Research and Manufacturers of America (PhRMA), the trade organization that represents the country’s largest and lead- ing drug companies, a senior vice presi- dent claimed that free samples improve patientcare,fosterappropriatemedication use or end up in an ‘‘unknown destina- tion’’[5,6].Andinonestudy,nearlyhalf usuallycomprisethenewestagentsonthe market. As such, they expose patients to risks not yet identified in clinical trials. The experience with Vioxx is a case in point. By 2002, only three years after Vioxxwasintroduced,itbecamethemost widely distributed sample [3], and two years later the drug was withdrawn from the market because of an excess risk of myocardial infarctions and strokes [9]. Needless to say, Vioxx was not the only druggivenextensivelyassamplesandlater found to enhance risk. Samples given to pediatric patients have similarly been associated with notable safety concerns. In 2004, four of the 15medications most frequentlygivenassamplestochildrenin the US received new or revised ‘‘black box’’ warnings from the US Food and Drug Administration within two years of approval[10].Finally,patientsmaynotbe the only ones at risk from distribution of freesamples.Physicianswhooffersamples to patients and fail to supply appropriate cautions and warnings about the use of these drugs may be subject to liability, alongwiththecompanythatpromotedthe drug[11]. of pharmaceutical representatives s