The economy is forcing some patients with pricey prescriptions to skip doses, cut pills in half or even stop taking potentially life-saving medications. But many are asking their doctors for help in the form of handouts -- free samples of expensive drugs from the pharmaceutical companies that make them.
"They show up with their hands out," said Dr. Howard Weintraub, clinical director for the Center for the Prevention of Cardiovascular Disease at NYU Langone Medical Center, describing patients who confess they "just can't afford" to take their medications. "Certainly you can see the frustration in their faces."
Like samples of cheese at the grocery store, free drug samples are intended to encourage patients to try, and ultimately buy certain drugs. But some patients say they need the freebies to bridge gaps in insurance coverage and offset healthcare costs through tough financial times.
Weintraub said it's obvious when patients are unable to take their medications as directed.
"They'll say, 'I am taking it; I don't know why my cholesterol's up," he said.
But the tests say otherwise.
"The drug didn't just stop working," Weintraub said.
The cholesterol-lowering drug Lipitor and the blood-thinner Plavix can cost up to $168 each per month. But skipping doses, Weintraub said, can cost patients their lives.
"These medications are extremely important in preserving cardiovascular health and preventing something you certainly want to prevent, like a heart attack, a stroke or death," he said.
Lipitor and Plavix are two of 10 blockbuster drugs coming off-patent in the next year, opening the door to cheaper generic versions that can drive down prices.
In the meantime, patients can keep asking for samples. But there are fewer samples to go around. Instead, drug companies are offering vouchers for discounted copays -- a move Weintraub said dissuades doctors from hoarding samples for the particularly needy.
Christine Lorenzo of Boston has noticed the decline in free samples.
"I used to see the salespeople coming in, dropping off samples and donuts," said Lorenzo, who has monthly appointments with a neurologist for migraines. "But they're not there as often now. In the past six months I haven't seen one suit in the office while I'm there."
After taking a pay cut at work, Lorenzo said she asked her doctor for free samples of her migraine drug Topamax.
"He knows I've had a hard couple of years; that I don't have extra money to spend but I don't want to skimp on being well because I have to take care of my kids," said Lorenzo, a 42-year-old single mother of two.
Although the patent on Topamax has expired, the generic version of the drug made Lorenzo sick. Asking for free samples, she said, can't hurt.
"Advocating for yourself is huge," Lorenzo said. "Everyone is so stunted financially. Decisions should be focused on health, not money."