Specialist physician perspectives on non-medical switching of prescription medications

Abstract

Introduction: A non-medical switch is a change to a patient's medication regimen for reasons other than lack of clinical response, side-effects or poor adherence. Specialist physicians treat complex patients who may be vulnerable to non-medical switching. Objectives: To evaluate specialist physicians' perceptions regarding the frequency of nonmedical switch requests, and the impact on their patients' outcomes and healthcare utilization. Methods: An online survey of randomly sampled physicians spending ≥10% of time providing patient care and having received ≥1 non-medical switch request during the prior 12-months. Results: Among 404 specialist physicians surveyed, non-medical switch requests were reported as very frequent or frequent by 35.0% of oncologists (for injectable cancer agents) and up to 80.3% of endocrinologists (for injectable anti-hyperglycemics). Respondents reported decreased medication effectiveness (25.0% of oncologists to 75.0% of dermatologists) and increased sideeffects (32.5% of oncologists to 66.7% of psychiatrists). Most specialists reported very frequent or frequent increases in non-office visits (52.5% of oncologists to 75.3% of endocrinologists) and calls with pharmacies (57.5% of oncologists to 80.5% of rheumatologists) due to non-medical switching. Conclusions: Receipt of non-medical switching requests were common among specialist physicians. Non-medical switching may lead to negative effects on patient care and require increased healthcare utilization. ARTICLE HISTORY

Impact of non-medical switching of prescription medications on health outcomes: an e-survey of high-volume medicare and medicaid physician providers

“…Nguyen and colleagues identified 29 studies published between January 2000 and November 2015 that evaluated the impact of non-medical switching on health outcomes (60.4% clinical, 21.9% resource utilization, 13.5% economic and 4.2% medication-taking behaviour outcomes), and subsequent analysis found outcomes following non-medical switching were more frequently negative (33.3%) or neutral (55.2%) in nature than positive (11.5%). Primary care physicians and specialists have previously reported frequently having reservations about the practice of non-medical switching; citing concerns regarding negatively impacted care, medical ethics and the administrative burden it imposes on their practice and staff [ 9 , 10 ]. Moreover, physicians have indicated their belief that insurers’ current level of communication regarding nonmedical switching is suboptimal [ 11 ].…”

Addressing Autoimmune and Immune-mediated Skin Disease Burden in Women

“…More than one-half of these individuals suffered from gaps in treatment during the administrative transition (Teeple et al, 2019). Furthermore, both patients and providers considered such changes to payer coverage policies to be an interference in the provider's ability to administer the most effective personalized treatment plan for their patients (Costa et al, 2020).…”

Interleukin 6 receptor inhibitors in the treatment of rheumatoid arthritis during the COVID-19 pandemic, Moscow experience

“…Риски, связанные с немедицинским переключением на фоне удовлетворительного эффекта текущей терапии, могут включать потерю контроля над заболеванием, возникновение НР, развитие эффекта «ноцебо» и снижение комплаентности пациента [14]. С точки зрения фармакоэкономических аспектов немедицинское переключение может привести к увеличению медицинских (госпитализации, обращения за неотложной помощью, амбулаторные посещения) и общих (медицинские и фармацевтические) расходов.…”