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We all like free samples and pharmaceutical companies realized a long time ago that it's a good way to get us hooked on their products.

In the United States alone, drug-company sales reps give away an estimated $16-billion (U.S.) worth of prescription medications to doctors, who in turn, hand them out to patients of their choosing. The companies, which also provide Canadian physicians with a liberal supply of drugs, contend the freebies can help off-set high drug costs for the poor.

But in a stinging critique of the industry practice, two academics argue that free samples - known as starter packs in the trade - do more harm than good.

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Low-income uninsured patients are in fact less likely to receive free samples than patients with insurance, according to research cited by Susan Chimonas of New York's Columbia University and Jerome Kassirer at Tufts University School of Medicine in Boston.

The samples are simply a marketing ploy - a way of getting a foot in the doctor's office, so the sales reps can make their promotional pitches. Indeed, many samples "are appropriated by physicians for personal and family use," the two industry critics write in the online journal PLoS Medicine.

Samples tend to be the latest - and usually most expensive - drugs on the market, not the run-of-the mill medications used for many years by millions of people.

That means patients who get samples of brand new drugs are exposed to potential adverse side effects not yet identified in pre-market clinical trials. Pain killer Vioxx, for instance, was a widely distributed sample before being linked to an increased risk of heart attacks and strokes.

And when doctors dispense drugs from their offices, there is no pharmacist looking over their shoulders. "In drugstores, pharmacists often identify potential harmful drug interactions, intercept inadvertent medication errors and offer a patient-friendly printout of instructions," they write.

To make matters worse, the freebies actually add to overall cost of prescription drugs. "Every penny they spend on marketing they are going to get back - if not more - in the price of their products," Dr. Chimonas said in an interview.

"If they really wanted to help us, they would make all kinds of medications available through samples," not just the high-priced drugs they want to promote, she added.

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