Polling results from Tennessee cast new light on a trend that’s sparking national concerns: non-medical switching. As the Tennessee Patient Stability Coalition reports, more than two-thirds of chronic disease patients have been driven to change medications due to reduced insurance coverage and higher out-of-pocket costs.
Chronic disease patients in particular depend upon medication to manage their disease and go about their daily lives. Yet nearly half reported that they had received no communication from their health plan about its formulary – or changes in prescription drug coverage. Once those changes forced them to switch medications, 95 percent reported that their symptoms grew worse.
Beyond worsening symptoms, patients also reported a range of negative consequences:
- 68% had to try multiple treatments before finding one that worked
- 48% were switched to a medication they had already used but discontinued because of side effects, ineffectiveness or cost
- 42% reported experiencing an adverse event on their new medication
- 89% reported worse side effects on their new medication
- 32% reported missing work as a result of their new medication and its complications.
The 85 patients polled represented various chronic conditions: autoimmune infectious, mental health, neurological, oncological, and others. Nearly all the patients polled expressed support for legislation to prohibit insurers from imposing non-medical switching on patients.
About Non-Medical Switching
Non-medical switching can occur when health plan actions drive patients to switch their treatment for reasons unrelated to their health. Changes may be due to formulary changes that eliminate or reduce coverage for certain drugs, requiring higher out-of-pocket costs from patients. Health plans may also eliminate the use of co-pay coupons that make drugs affordable. And, in some cases, health plans institute incentive programs that encourage pharmacists or physicians to provide or prescribe lower-cost drugs.
[WATCH: Understanding Non-Medical Switching]
The Tennessee switching study was conducted in partnership with the nonprofit Global Healthy Living Foundation and Creaky Joints, an online patient community of more than 100,000 people with arthritis and their families. Learn more here.