Many Sample Closet Medications Are Expired

Ricki Lewis, PhD

June 07, 2012

June 7, 2012 — An investigation of expiration dates of the contents of sample closets reveals that on average, 14% of the samples were past their prime. The results are published in the May-June issue of the Journal of the American Board of Family Medicine.

A high percentage of internists, family physicians, cardiologists, and other practitioners accept drug samples from pharmaceutical companies, and many of them give these samples to their patients, according to several studies. Patients and staff often use them, but little is known about the likelihood that a sample will have expired.

Kari L. Evans, BS, from the University of Arizona College of Medicine, Phoenix, and Steven R. Brown, MD, from the Banner Good Samaritan Family Medicine Residency, Phoenix, inventoried sample closets in 7 family practice and 3 general internal medicine offices in the Phoenix area. Six were group practices, 4 were solo practices, 5 were affiliated with hospitals, and 5 were private practices. The cross-sectional study recorded drug name, number of units, dosage, and expiration date.

Results were quite varied. Two sample closets contained no expired samples. On the other hand, the highest percentage of expired samples was 28%. Of the 12,581 sample drug boxes/packages, 1698 (14%) were past their freshness date.

The researchers advanced 2 explanations for the "substantial numbers of expired medications." The first is the lack of a reliable inventory system. Indeed, they discovered great variability in how the practices organized their sample closets. Organization requires great effort, the authors note.

The second possible explanation for why closets contain so many expired drugs is that the samples are not consistent with the drugs most prescribed by a particular practice.

The authors extrapolated their findings to indicate a waste of $2.2 billion a year in the collective sample closets of the United States and call for a reexamination of the practice of giving patients samples of medications.

The authors have disclosed no relevant financial relationships.

J Am Board Fam Med. 2012;25:394-395. Abstract