The article headlined "Free Samples: Win-Win Situation" in the August 18 issue describes a study by Leo Bastiaens, M.D., and colleagues showing that patients who receive medication samples are more likely to take their medications during the first week of treatment.

Unfortunately, the article ignores the cost of drug samples. "Free" samples are a marketing tool used by pharmaceutical companies to gain access to physicians and promote their products. Although most physicians believe they are immune to improper influence by pharmaceutical representatives, many studies have found correlations between meetings with pharmaceutical representatives and changes in prescribing practices, including nonrational prescribing, according to the article "Physicians and the Pharmaceutical Industry: Is a Gift Ever Just a Gift?," which appeared in the January 19 Journal of the American Medical Association.

Medication nonadherence is a serious problem. The study’s findings are intriguing and highlight the importance of increasing patients’ convenient access to

prescribed medication. But samples from pharmaceutical representatives are neither free nor a simple win-win solution to the problem of nonadherence.

Burns Woodward, M.D.

Waban, Mass.