Pharmacy Times

Medication Samples and Safety Concerns for Physician Practices

Author: Michael J. Gaunt, PharmD

The use of medication samples in clinical practice needs to be re-evaluated to keep patients safe.

In a 2012 study, researchers found that up to 14% of medication samples in prescribers’ offices were expired.1 Of the estimated $16 billion in medication samples given out per year, the authors estimate approximately $2.2 billion in medication samples is wasted each year. Additionally, these outdated medications could prove detrimental if they are provided to patients or if used personally by the physician or office staff.

The lack of organization, inventory control, and storage space for samples in office closets may be major contributing factors to such a high percentage of expired medications. In addition, some drug companies may send medication samples to clinicians who never actually distribute them in their practice; these medications sit in the physician’s closet until they are discarded.

Inadequate systems also may exist for distributing sample medications to patients. For example, samples are frequently dispensed without computer screening for drug interactions, duplicate therapy, allergies, or contraindications, and without an independent check by a second individual. Patient education may be limited or narrow in scope,2 and drug recalls may be overlooked. Medication samples also may have problematic or confusing labeling and lack specific patient labeling (eg, patient name, directions for use, warning labels).

The use of medication samples in clinical practice should be reevaluated in order to keep patients safe. In fact, a safer alternative to dispensing medication samples from physician practices is the use of medication vouchers; manufacturers should consider distributing vouchers that prescribers can give to patients to redeem at community pharmacies for a free trial of a medication. If distribution of medication samples continues, practitioners should follow a standardized approach to reduce the risk of medication errors. Below are some risk-reduction strategies physician practices and pharmacies should consider:

Dr. Gaunt is a medication safety analyst and the editor of ISMP Medication Safety Alert! Community/ Ambulatory Care Edition.

  1. Evans K, Brown S. Many sample closet medications are expired. J Am Board Fam Med. 2012;25(3):394-395. Accessed July 2013.
  2. Aseeri MA, Miller DR. Patient education and counseling for drug samples dispensed at physicians’ offices. J Am Pharm Assoc. 2006;46(5):621-623.
  3. National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP). Recommendations for avoiding medication errors with drug samples. Published 2008.Accessed July 2013.