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No More Free Drug Samples 英文参考文献
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years later the drug was withdrawn from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
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