OCTOBER 01, 2005
Mike Faden

To help increase use of generic prescription drugs—and counter the massive detailing efforts of brand name pharmaceutical companies—some insurers are hiring a mechanical assistant: an ATM-like sample-dispensing machine installed in doctors' offices.

Close to 100 of the Sample Center machines have been installed in 5 states in pilot programs and have dispensed about 60,000 samples over the past 2 years, according to their supplier, San Diego-based MedVantx. Each machine contains prepackaged 30-day supplies of 20 or so generic drugs in different therapeutic classes, such as statins and proton pump inhibitors.

The machines are paid for by health insurers, such as Wellpoint of Thousand Oaks, Calif; Highmark of Pittsburgh, Pa; and Horizon Healthcare Services. Each company pays a transaction fee when a machine provides samples to a patient covered by one of its plans.

The payers hope that more generics sampling will lead to higher generic dispensing rates and lower drug costs. Although there have been previous attempts to sample generics, those efforts are small compared with the sales representative visits that keep doctors' cabinets well-stocked with branded drug samples.

"We see [it] as a counterbalance to the pharmaceutical company detailing," said John Frederick, chief medical officer at PreferredOne, a health benefits administrator in Golden Valley, Minn, that recently subscribed to the service. "In many cases, if a doctor is able to supply a patient with a sample of a generic, he is not going to grab a sample of a branded drug off the shelf."

To use the system, a doctor enters a passcode and scans the patient's billing information. The machine then ejects a sample and prints a drug information sheet. MedVantx claims the process can take as little as 15 seconds.

Highmark recently estimated that the system could produce at least modest savings. The company analyzed generics prescribing in 10 physicians' offices over 1 year, comparing a group of patients that had access to the system with one that did not. In the end, the rate of prescribing generics was just 0.6% higher, at 51.3%, in the group with MedVantx access. But that added up to a savings of about $100,000, twice what the company paid MedVantx for the service, according to Robert Wanovich, Highmark's manager of clinical services and product development.

Realizing that it is hard to get insurers to pay to give away drugs, MedVantx initially aims to get about 50% of insurers in each state to subscribe to the service, said MedVantx CEO Robert Feeney. Doctors, however, can provide samples to patients whether or not they are covered by one of those insurers.

By subscribing, payers get information about dispensing behavior. At the end of each day, a Sample Center transmits details about the samples it has dispensed to MedVantx, which forwards the information to insurers. Doctors do not need to worry about the generics cabinet running out of samples; while sending other information, the machine also can let MedVantx know if it needs to be restocked.

Mr. Faden is a freelance medical writer based in Portland, Ore.

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