Prescription medicine samples are a product based promotion designed to facilitate brand switching or uptake of a new product. Marketing of pharmaceuticals differs from other products since the primary decision maker (doctor) is not the ultimate consumer (patient). Marketing of medicines also has an overlay of government regulations and political influence. It is argued whether free samples of prescription medicines provided to doctors constitute a “gift” or a trial quantity with which to initiate therapy and test patient tolerance of the drug concerned. Either way, samples are an integral part of the prescription medicine marketing tapestry and they have become woven into the “fabric” of drug promotion. The international literature abounds with papers describing pharmaceutical promotion and myriads of surveys obtaining prescribers’ opinions about pharmaceutical promotion. Few studies have been conducted or reported to ascertain the reasons behind the opinions expressed as disagreement/agreement scales to specific statements. Interventions to alter practice targeting alternative methods of distribution of samples (rather than direct from company to prescriber) are also rare; therefore the aim of this research was to qualitatively explore opinions regarding samples to develop an intervention to ensure samples do not have an adverse effect on prescribing practice and to test the model in a practice environment. In order to assess the place of samples within the totality of pharmaceutical promotion, a model was derived from the literature and tested with a hypothetical, but realistic practice-based scenario. This highlighted the interplay between the various methods involved in pharmaceutical promotion, their target audiences and the potential interplay and synergism that could be achieved through a co-ordinated campaign. Quantification of the expenditure on samples was also required in the Australian context to assess the potential impact of interventions targeting this promotional mode. Samples were found to account for approximately 5% of the total marketing spend in Australia. No clear relationship could be found between sample expenditure and drug sales, utilizing data on the proton pump inhibitor therapeutic class. However, a pattern of decaying spending was found between the amount spent on samples per unit pack dispensed and the time a product had been available on the market. A range of interested parties were then interviewed to gain their opinions about free prescription medicine samples. The interviews were split into two groups: consumers, pharmacists and practicing general practitioners (GPs) provided an operational level focus, while a range of key informants from organisations involved in Quality Use of Medicines in Australia provided a strategic overview. The transcripts of the focus groups and interviews were qualitatively analysed to extract key themes which were quite similar. Examples included ‘pay’ in the operational group compared to ‘cost’ in the strategic group. These concepts express a similar sentiment, yet ‘pay’ is a more personal action whereas ‘cost’ does not imply who must meet the financial outlay. These resultant themes formed the basis of the intervention developed to pilot in a practice environment to assess its practicality for wider study. In addition to the extensive interview process, a mail survey was conducted in three divisions (geographical groupings) of general practice. Each family doctor (General Practitioner (GP)) and community pharmacist within the divisions received a questionnaire to gather their opinions about samples. This was the first time GPs and pharmacists had been surveyed simultaneously to gather comparative results. No differences were found between the metropolitan division and the accumulated results from the two regional divisions. Pharmacists and GPs differed predominantly in their perceptions of promotional influence of samples, appropriateness of self use and meeting legal requirements for labelling dispensed medicines. These factors were incorporated in the pilot study design. An action research methodology was utilised to assess the practicality of community pharmacist dispensing of starter packs for antihypertensives and antidepressants in two regional GP practices in Queensland, Australia. In this pilot study, a total of 32 starter packs were prescribed to 31 patients over the four months of the intervention period, with 29 (91%) dispensed at a study pharmacy and 17 (53%) of subsequent full prescriptions able to be tracked through Medicare Australia data or the study pharmacies. Antidepressants comprised the majority of prescriptions (n=16, 55%) Each of the 29 patients who received a starter pack completed a patient survey which demonstrated high levels of support (n=22, 76%) for the model in the pilot. GPs and pharmacists involved in the pilot were also generally supportive of the pilot model. In conclusion, opinions held about free prescription medicine samples by a wide range of apparently disparate groups show similar themes and community pharmacist involvement in dispensing starter (or sample) packs has general acceptance. The model piloted in this research was applicable in daily practice for general practitioners and community pharmacists in Australia. Consumers accepted the pilot model as an acceptable change to current procedures. The research presented in this thesis provides a solid foundation for development of a more widespread trial for dispensing of all prescription medicine starter packs through community pharmacies to be rigorously evaluated in Australia.

This master thesis analyses factors that determine the prices of prescription medicine. The theoretical part is outlining the fundamentals of pharmaceutical market, identifying the main price components and determinants with main focus on pricing and reimbursement policies in the world. The empirical part is dedicated to the pharmaceutical market in the Czech Republic. It explores the impact of state regulatory measures such as internal and external reference pricing on the prescription medicine prices. A regression analysis was conducted to determine what factors have significant impact on the prices. Furthermore a t-test was performed to discover differences in price levels between regulated and unregulated drugs as well as between originator medicine and generics.