Drugs: Getting the Care You Need (cont.)

Pharmacies at these clinics, which serve the working poor, do not have a ready supply of drugs to fill prescriptions immediately. Medications are obtained on a patient-by-patient basis, and patients must often wait three to four weeks to receive them. The majority of the programs give a patient enough medication to last three months.

To fill the gap, Smarinsky says the clinic relies on free samples that drug company representatives bring with them when they visit the clinic. The reps make these visits fairly often, because the Venice clinic sponsors a residency program that includes 500 volunteer physicians. "[The drug rep visit] is inexpensive marketing for [the company]," says Smarinsky. Although obviously beneficial for clinics and patients in some situations, such close collaboration between health professionals and drug companies remains controversial. ( See A Prescription for Trouble)

In return for the drug rep's one-stop office visit, Smarinsky gets what her clinic needs -- a way to help bring relief to clinic patients while they wait for their prescription drugs to arrive. "We wouldn't have a pharmacy without the samples or the [patient assistance] programs," she says.

When You're On Your Own

But those who do not have a clinic operating on their behalf may have to take the initiative and go directly to the company themselves. (For more information, see Cracking the Secret.) If, like Suzanne, they are unable to get insurance coverage, they may be fortunate enough to receive the drug from the company.

This work by the drug companies has obvious benefits for the patients, says Lewis, but it also has perks for the drug companies as well. The Berkeley hematologist recalls a case 16 years ago when he wanted to give Alpha Interferon to a patient with myeloma, but the patient had been refused coverage. At the time, two companies were making the drug, but only one would help Lewis' patient by giving the drug for free.

"For many years I only used that company's brand [of Alpha Interferon], and most of my colleagues followed in my footsteps. It was four or five years before I would use the other company's drugs," he says.

Kristi Coale is a San Francisco-based freelance journalist who specializes in science and medical issues. Her work has appeared in Salon, Wired, and The Nation.

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Last Editorial Review: 1/30/2005 10:58:45 PM