Specialist physician perspectives on non-medical switching of prescription medications

Olivia S Costa; Tabassum Salam; Amy Duhig; Aarti A Patel; Ann Cameron; Jennifer Voelker; Brahim Bookhart; Craig I Coleman

doi:10.1080/20016689.2020.1738637

Specialist physician perspectives on non-medical switching of prescription medications

J Mark Access Health Policy. 2020 Mar 9;8(1):1738637. doi: 10.1080/20016689.2020.1738637. eCollection 2020.

Authors

Olivia S Costa^{1

2}, Tabassum Salam³, Amy Duhig⁴, Aarti A Patel⁵, Ann Cameron⁴, Jennifer Voelker⁵, Brahim Bookhart⁵, Craig I Coleman^{1

2}

Affiliations

¹ School of Pharmacy, University of Connecticut, Storrs, CT, USA.
² Evidence-Based Practice Center, Hartford Hospital, Hartford, CT, USA.
³ Medical Education, American College of Physicians, Philadelphia, PA, USA.
⁴ Consulting Services, Xcenda, Palm Harbor, FL, USA.
⁵ Real World Value and Evidence, Janssen Scientific Affairs, LLC, Titusville, NJ, PA, USA.

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 non-medical 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 side-effects (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.

Keywords: Non-medical switch; outcome assessment; specialization; therapeutic interchange.

Grants and funding

This work was financially supported by Janssen Scientific Affairs, LLC, to Xcenda, a health economics consultancy providing services to the life science industry.