Empowered Patient, a regular feature from CNN Medical News correspondent Elizabeth Cohen, helps put you in the driver's seat when it comes to health care.
The free samples given in doctors' offices are often for expensive medications.
ATLANTA, Georgia (CNN) -- Last week, Dr. Richard Adair's doctor offered him a free two-week supply of prescription skin cream to treat his actinic keratosis, a skin condition on Adair's sun-damaged scalp.
Adair said no thank you.
What in the world is wrong with him? Why would anyone in their right mind say no to something free?
Because, as David Rothman, a professor of social medicine at Columbia College of Physicians and Surgeons puts it: "Samples look like they're free, but they're not."
Simply put, samples don't last forever. They're often for very expensive medicines, and when they run out, you (or your insurance company, or both) can be left with a high price tag.
Take Adair's drugs. His doctor offered him a sample of a prescription cream called Aldara. Adair, a University of Minnesota professor who researches physician prescribing habits, checked it out afterward, and found Aldara costs $309.57 for a two-week supply. The cost for fluorouracil, a generic prescription cream Adair has been using with good results for five years: $74.84 for two weeks.
It appears Adair's case isn't an anomaly. A new study has found that when people receive samples, they end up spending more money on drugs. In a University of Chicago study published this month, those receiving samples spent $166 in the six months before they obtained free medicine, $244 when they received the samples, and $212 in the six months after that. Patients who never received free samples spent an average of $178 for six months in prescriptions.
So, given that free samples aren't always so free when you look at it long-term, what should you do when your doctor offers you a free sample?
1. Ask your doctor how long you'll be taking the drug
If you need it for only a week and your doctor has given you a week's supply, then you could be in luck.
"This might be one of the few circumstances where taking a sample would be the reasonable thing to do," Adair says.
2. Your clever idea might not work
We know what you're thinking: If you need a drug for, say, three months, take the one-month supply of the free (expensive) drug, and then switch to the cheaper drug when the freebies run out.
It's a clever idea, but doctors are often hesitant to change a prescription -- if a drug works, they might not want to switch you, Adair says.
3. When offered a sample, ask your doctor if there's a cheaper alternative.
This might make some people uncomfortable, since doctors are authority figures, and in a way, you're questioning their judgment.
Adair says you could phrase it this way: "Doctor, I'm struggling with costs. Would you partner with me in this regard?"
You shouldn't be embarrassed if you're having trouble paying for your medications; you're in good company. In a study published a few weeks ago, Adair and his team asked 750 patients at a private practice doctor's office if they'd skipped medication in the past year because they couldn't afford it. Forty percent said yes.
Gail Shearer, director of Consumer Reports Best Buy Drugs, says when a doctor offers samples, you can try saying this to the doctor: "I'm not sure what coverage I have for this [sample] medication. Are there alternatives?"
4. Ask your pharmacist to call your doctor
Let's say you accept your doctor's free samples, and when they run out you get hit with sticker shock at the pharmacy.
"The pharmacist can't switch your drug, but the pharmacist can call the doctor and suggest less expensive alternatives," Shearer says.
5. Do your own price shopping
If you have a chronic condition, do your own price comparison. This way, when your doctor hands you a sample, you'll know if it's for an expensive drug, and if there's a less expensive alternative.
Consumer Reports Best Buy Drugs offers cost comparisons for drugs used to treat many conditions, from ADHD to ulcers. AARP also has a price comparison guide. And remember: Samples don't come with the list of side effects that you get when you buy a drug at the pharmacy. To find information about side effects, go to the FDA's Web site.
Now, back to Adair and his skin condition. You might be wondering why his doctor gave him samples for a new (expensive) drug when the (inexpensive) drug he'd been using for years was working just fine.
"He was being nice to me, or he thought he was," says Adair. "Doctors think they're helping people by giving free samples, but we don't think through the long-term consequences." E-mail to a friend
CNN Medical News senior producer Jennifer Pifer and associate archive coordinator Sarah Edwards contributed to this report.