Free Drug Samples Carry Risks For Children

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Free Drug Samples Carry Risks For Children

http://medicalnewscenter.com/out/out.cgi?

http://www.sciencedaily.com/releases/2008/10/081006092522.htm

Free prescription drug samples distributed to children may be unsafe,

according to a study by physicians from Cambridge Health Alliance and

Hasbro Children's Hospital. The national study, the first to look at

free drug sample use among children, appears in the October 2008

issue of Pediatrics.

The authors, who also serve as researchers at Harvard Medical School

and the Warren Alpert Medical School of Brown University, found that

children commonly receive free drug samples from their doctors. One

out of every 20 American children received free drug samples in 2004.

Among children who took at least one prescription drug in that year,

nearly one in 10 got free samples.

The U.S. Food and Drug Administration identified significant new

safety concerns for four of the top 15 most frequently distributed

samples in 2004. These four medications acquired new black box

warnings or had significant revisions to existing black box warnings

issued since 2004. In addition, two of the top 15 sample medications

given to children were schedule II controlled substances (drugs

controlled and monitored by the Drug Enforcement Agency due to high

potential for abuse). Distribution of these medications, Strattera

(atomoxetine) and Adderall (amphetamine/dextroamphetamine), carries

risk, especially when drug sample closets in physician's offices (or

home medicine cabinets) are not strictly monitored.

Although some physicians support the use of free drug samples as a

way of getting medications to indigent patients, lead author Dr.

Cutrona and colleagues found that few free samples in their

study go to needy children. More than 80 percent of children

receiving samples were insured all year. Conversely, approximately 16

percent were uninsured for all or part of 2004, and less than one-

third had low family incomes (under $38,000 for a family of four).

Minority children were less likely to receive free samples than white

non-Hispanic children, and free sample receipt was positively

associated with markers reflecting access to health care. The authors

concluded that free sample distribution does not equalize medication

access for needy children.

Dr. Cutrona, a physician at Cambridge Health Alliance and an

instructor of medicine at Harvard Medical School, commented, " New

medications are frequently released before their safety profile is

fully understood, and samples tend to be newer medications. Free

samples encourage the casual use of medications in our children

before enough is known about potential harm. As a mother of young

children, I find that very concerning. "

Senior author Dr. Neal LeLeiko, director of pediatric

gastroenterology and nutrition at Hasbro Children's Hospital, and a

professor of pediatrics at the Warren Alpert Medical School of Brown

University, added, " Previous findings in adults strongly suggest that

free drug samples serve as a marketing tool. Our study shows that

samples can pose a serious and unappreciated risk to our children. "

The study used data on 10,295 US children and adolescents from the

2004 Medical Expenditure Panel Survey (MEPS), an annual federal

survey. Dr. Cutrona's work was supported under a National Research

Service Award to Harvard Medical School.