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Health plans’ attempts to cut costs can wreak havoc on patients’ lives, new research makes clear.

In a first-of-its-kind study, the Alliance for Patient Access reveals that non-medical switching, where insurers or pharmacy benefit managers drive stable patients to switch to lower-cost medicines, can levy widespread damage on patients’ quality of life.

In a statement from the Alliance for Patient Access, Executive Director Brian Kennedy explained, “Non-medical switching too often undermines a patient’s health and results in increased health care expenditures; that much was already understood.  But this study, for the first time, establishes that the qualitative impact on a patient’s daily life can be equally devastating. The data shows that non-medical switching chips away at nearly every facet of patients’ lives, from their health to their family life and work productivity to their emotional well-being.”

Key Findings

The study, which entailed two in-person focus groups followed by a national online poll of 800 patients who had endured a non-medical switch, revealed that non-medical switching most often occurs due to the insurer:

Patients most often find out about the switch at the pharmacy counter (48%).

The switch can come as a real blow.  Patients reported:

The situation doesn’t get any better from there.  Patients reported a slew of consequences, from an impact on their health to increased health care utilization.

Effect on Home Life & Work Life

Patients also revealed that the non-medical switch impacted their home life, reporting that:

Work and civic responsibilities also suffered.  Patients responded that:

Impact on Physician-Patient Relationship

The switch undercuts patients’ relationships with their health care providers, who otherwise emerged as patients’ trusted allies throughout the non-medical switching experience:

Emotional Impact & Medication Abandonment

Finally, respondents admitted that the switch left them feeling:

For some, it was just too much.  Almost 40 percent of patients reported that being switched was so frustrating that it led them to stop taking their medicine altogether.

Policy Solutions

Could better policy help patients?  The patients in AfPA’s study think so.  They suggested that lawmakers:

Related Research

AfPA’s findings can be found in the full report as well as the condensed research abstract.

This study complements 2017 research by the Institute for Patient Access, which examined whether non-medical switching saves money for the health care system.  That study found that cost-motivated medication switches lead to higher non-drug medical costs for services like doctor’s visits, hospitalizations and ER visits for several chronic disease states.

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