Forced Non-Medical Switching:

Practicing Medicine Without A License

Health insurers are forcing many people with diabetes to switch from their current medication to another for non-medical reasons. This practice is referred to as “forced non-medical switching”. As a result, many Americans with diabetes are having difficulty obtaining their prescribed medications and/or medical devices.

This insidious practice not only places additional financial burden on people with diabetes and their families but jeopardizes patient safety and long-term clinical outcomes. A recent study found that forced non-medical switching was associated with negative effects on economic outcomes (e.g., medical or treatment costs) and medication-taking behaviors, particularly among individuals with stable, well-controlled disease.

Non-medical switching graphic showing increases co-pay and off formulary arrows

Forced non-medical switching can happen in one of two ways:

  • The insurer stops covering the medication or medical device, forcing patients to pay out-of-pocket for the medication/device that is already working well for them.
  • The insurer increases patient co-pays, resulting in additional financial hardship for a disease that is already too expensive.

In both scenarios, individuals must choose between continuing with their current treatment at an increased out-of-pocket expense or switch to treatment that may not be as effective (or even dangerous), which could lead to worsening diabetes control.

What You Can Do To Help Stop Non-Medical Switching

To put a stop to this practice, we need to know if you have experienced forced non-medical switching data, either as a patient or healthcare professional. If so, we need to know how it has impacted you. This information will allow us to put pressure on insurers, legislators and regulatory agencies to reform the practice of non-medical switching.

Children with Diabetes (CwD) is a 501(c)(3) non-profit organization that provides education and support to individuals and families living with type 1 diabetes. The organization has recently established a website (www.MyMedsMyChoice.org) to gather basic information from with all people with diabetes (or their caregivers) and healthcare professionals about their experiences with non-medical switching. The website links to two short surveys: Patient/Caregiver and Healthcare Professional.

 

Click here to take the survey and help gather this important data!

Link to MyMeds My Choice website for non-medical switching

 

The Diabetes Patient Advocacy Coalition (DPAC) supports this initiative and urges you to go to the website and complete the short Patient/Caregiver or Healthcare Professional survey. DPAC’s statement on non-medical switching can be found here. 

I think we can all agree that addressing the rising cost of healthcare should remain a high priority for everyone. However, the practice of forced non-medical switching in individuals who are stable on their current diabetes medications and medical devices is dangerous, indefensible and shameful.

I believe that anyone whose diabetes is stable or well-controlled should be allowed to continue with the medication, treatment and self-management devices that is allowing them to succeed without the burden of non-medical switching. Treatment and medications should be designed, recommended and prescribed by the patient and his/her medical team — not by an insurance company for economic reasons.


Christopher G Parkin guest post author on forced non-medical switchingChristopher G. Parkin is President of CGParkin Communications, Inc., a consulting firm that specializes in diabetes education development. During the past 30 years, Chris has authored numerous articles on diabetes technology and management and has assisted several medical organizations in the development of clinical practice guidelines, position statements and consensus conference reports regarding diabetes management. Chris received a Master of Science degree in education and instructional design in 1996 from Indiana University, Bloomington and served as Adjunct Professor at Indiana University.


To learn more about non-medical switching and how it hurts people with diabetes, watch this video: