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For many mental health patients, successfully managing their condition would be much simpler if they had uninterrupted access to the medication their provider prescribed for them.

Insurance companies and pharmacy benefits managers frequently use a tactic called non-medical switching to force stable patients to switch from their clinician-prescribed medication to a company preferred one. Most often, the change financially benefits the insurer – and disregards the patient’s best interest.

Pressing for Congressional Action

Non-medical switching has long been an issue and it’s now on Congress’ radar.

Last month, more than a dozen mental health advocacy groups shared their perspective on the subject, urging greater patient protections. The groups sent a letter stressing the importance of ensuring that people with mental health conditions have “broad and consistent access to medications they rely on.” This includes “adequate protections” from harmful switching.

In the letter, advocates also asked for the Senate to authorize a special report on the subject to increase attention about its harms and generate even more compelling data to support reform. They noted a special commission created by Massachusetts’ legislature in 2017, which found that non-medical switching was common in the state and that mental health patients were among those most harmed by the practice. The Massachusetts report was used to usher in policy changes there.

Life-Threatening Side Effects

Over half of patients with serious mental disorders such as schizophrenia, bipolar disorder and depression struggle with medication adherence.  These patients are often in denial about their diagnosis and need for medication. Health plan barriers can deepen patients’ skepticism and being forced to change medications can exacerbate their adherence challenges.

This can result in physical side effects, preventable hospitalizations and, in some cases, raising the risk of suicide.

Providing Peace of Mind

Patients who are needlessly switched from the medications that keep them stable befall unnecessary – and preventable – hardships. Policymakers should be commended for their commitment to tackling the issue.

Provisions negating non-medical switching will protect patients’ health and give people with mental health conditions the “confidence and peace of mind” that comes with consistent access to their medications. That should be worth more than insurers’ bottom line.

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