Pennsylvania is taking steps to limit insurance companies from forcing patients to switch medications based on cost.
H.B. 2113 would prohibit a health care plan from ceasing to cover a prescription drug during a contract year if a patient is stable on their medication by amending the Unfair Insurance Practices Act of 1974. In February of 2018, the bill was referred to the Consumer Affairs committee, and it remains under committee review now. Section 5(a) of the bill prevents an insurance company from:
“Altering the coverage provided by a health insurance policy, including, but not limited to, raising the premium, copayment, coinsurance or deductible or denying or otherwise failing to provide continued coverage for a health care benefit that was included in the insured’s health insurance policy and when the insured has already received the health care benefit.”
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. This issue is further 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 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.