Two leaders of the Alliance for Patient Access discussed results of a survey and focus group about nonmedical switching of patients from one drug to another by payers and pharmacy benefit managers for reasons of cost.
During a session at the Alliance for Patient Access 4th Annual National Policy and Advocacy Summit on Biologics and Biosimilars, a conversation addressed the topic of nonmedical switching and the impact on patients.
Brian Kennedy, the executive director of the Alliance for Patient Access (AfPA), and David Charles, MD, the chairman of AfPA, discussed results of a survey and focus group that the organization released in February 2019. AfPA opposes switching patients from one drug to another by payers and pharmacy benefit managers for reasons of cost. The survey asked questions about the impact of nonmedical switching on work and home activities, and symptoms such as anxiety.
Nonmedical switching can be “disrupting and damaging,” the survey concludes.
“Do your patients perceive this?” Kennedy asked Charles, a neurologist and chief medical officer at the Vanderbilt Neuroscience Institute.
Charles described caring for patients who are stable, and then switched. “You can imagine how that patient feels,” he said. “Someone wants to come in the room and turn everything upside down.”
What concerns him as a physician, he said, is that according to the study, after being switched, 40% of the patients stopped taking the medicine altogether.
“The patient keeps paying deductibles and they get nothing,” he said.
The organization also feels that nonmedical switching interferes in the doctor-patient relationship, and also drives up other costs elsewhere as a result of the patient stopping their treatment.
Kenny called it being “penny wise and pound foolish.”
“That chronic disease is not going away just because it’s January 1,” he said, referring to the start of another plan year.
Other results of the study found:
In addition, 40% said the new medicine was not as effective as the original, and almost 60% experienced a complication from the new medication.
The results came from in-person focus groups of patients who had experienced non-medical switching as well as an online survey with 800 patients.
Those in attendance were cheered by a state law in Maine that requires 60 days’ notice of a change in the formulary; a notification requirement and a method to request an exemption for a patient; continued coverage during the exemption process, and an explanation for the change and the impact of any formulary changes.
Even though the law only applies to state employees or those on an exchange plan, it “puts the physician and patient in a stronger position,” said Kenny.
Biosimilar Market Development Requires Strategic Flexibility and Global Partnerships
April 29th 2025Thriving in the evolving biosimilar market demands bold collaboration, early global partnerships, and a fresh approach to development strategies to overcome uncertainty and drive future success.
Insights from Festival of Biologics: Dracey Poore Discusses Cardinal Health’s 2024 Biosimilar Report
May 19th 2024The discussion highlights key emerging trends from the Festival of Biologics conference and the annual Cardinal Health Biosimilars Report, including the importance of sustainability in the health care landscape and the challenges and successes in biosimilar adoption and affordability.
Addressing Patent Abuse, Reimbursement Models Key to Sustainable Biosimilar Market
April 25th 2025Sonia T. Oskouei, PharmD, emphasized strategies to streamline regulations and evolve to overcome barriers and expand the availability of cost-effective biosimilar treatments across more therapeutic areas.
What AmerisourceBergen's Report Reveals About Payers, Biosimilar Pricing Trends
May 28th 2023On this episode of Not So Different, Tasmina Hydery and Brian Biehn from AmerisourceBergen discussed results from a recent survey, that were also presented at Asembia 2023, diving into the payer perspective on biosimilars and current pricing trends across the US biosimilar industry.
Decade of Biosimilars Yields $36 Billion in Savings and Strengthens Supply Chain
April 24th 2025Dracey Poore, MS, director of biosimilars and emerging therapies at Cardinal Health, highlighted that biosimilars saved $36 billion over the last decade by improving patient access and the supply chain, but continued education and a robust pipeline are crucial for future growth.
Early Success of Adalimumab Biosimilars Featured at AMCP 2025
April 5th 2025High adherence rates, comparable clinical effectiveness, and cost savings have marked the early adoption of adalimumab biosimilars in the US, particularly in formulary-driven transitions, as shown in 2 retrospective studies presented at the Academy of Managed Care Pharmacy annual meeting (AMCP 2025).