DRUGS: Easing Pains In the Wallet

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Money-back guarantees have long been used to promote mail-order kitchen knives or lawn trimmers, but now that classic gimmick is helping sell a most unlikely product: prescription drugs. G.D. Searle -- best known for introducing the first birth-control pill and NutraSweet, the widely used sugar substitute -- is offering full refunds to customers who find the company's medications ineffective or experience unpleasant side effects. All a patient has to do is fill out a postcard-size form with information about where the drug was bought and how much it cost, and attach the sales receipt. The patient's physician signs the form, sends it in, and Searle mails the check to the --customer.**$

Searle, based in Skokie, Ill., will give refunds on all its 22 prescription drugs, including Calan, a drug for high blood pressure. The company hopes the promotion will boost sales. In particular, Searle thinks the money-back guarantee will encourage doctors to try prescribing several new drugs, including an anti-ulcer pill called Cytotec, that the company plans to market soon. But many doctors are uneasy about the strategy. Says Dr. Mark Siegler, director of the University of Chicago's Center for Clinical Medical Ethics: "Inappropriate guarantees from the drug firm threaten to undermine the doctor-patient relationship."