CVS Caremark, a pharmacy benefit manager for many insurance plans, has changed its formulary as of July 1. The change comes in the middle of the year, when policyholders have no opportunity to choose a different insurance plan that may cover the drug or supply they use. This means that many patients who are stable on their medications and devices will now have to switch to a comparable product. This practice is forced non-medical switching at its worst.
What CVS Caremark Changed
CVS Caremark has announced drastic changes to its formulary, or list of prescription drugs, devices, or supplies that they will cover. Some popular diabetes supplies affected by this change include all Humalog products (replaced with Novolog), Apidra (replaced with Fiasp), Lantus and Toujeo (replaced with Basaglar, Levemir, or Tresiba), all blood glucose test kits and test strips (replaced with OneTouch), and Jardiance (replaced with Farxiga or Invokana). See the full removal list here.
The Impact of Forced Non-Medical Switching
Non-medical switching negatively impacts patients by disrupting their care and does not generate cost savings for the patient or the insurer. A recent NIH study found that patients who had been switched off their preferred medication had more doctor office visits, experienced new or worse medication side effects, and had problems with their new prescriptions not working.
Non-medical switching is even more complicated for people with diabetes because insulins on the market are not identical. When a patient is switched from one insulin to another, the patient’s dosing and administration requirements may change. DPAC has done several posts on non-medical switching. You can read DPAC’s statement, read a patient’s view on non-medical switching, and read a guest blog by Christopher G. Parkin.
Make a difference today!
So what can you do? Several states have taken legislative action, and you can write a letter of support through DPAC if you live in Illinois, Pennsylvania, or New York. (These states have bills in the state legislature that would change non-medical switching practices.) Just click on the state name to be taken to the action site!
If you’re not in one of those states, you can still do something! Consider contributing your story of being non-medically switched to My Meds My Choice, a survey for patients, caregivers, and healthcare professionals that will provide data on non-medical switching.
Finally, if your state is not considering legislation to ban non-medical switching, you can make a huge difference by setting meetings with your representatives and asking them to introduce legislation on this issue! You can use DPAC’s statement as a jumping off point.