Impact of non-medical switching of prescription medications on health outcomes: an e-survey of high-volume medicare and medicaid physician providers
Background: Non-medical switching refers to a change in a stable patient’s prescribed medication to a clinically distinct, non-generic, alternative for reasons other than poor clinical response, side-effects or non-adherence. Objective: To assess the perceptions of high-volume Medicare and/or Medica...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2020-01-01
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| Series: | Journal of Market Access & Health Policy |
| Subjects: | |
| Online Access: | http://dx.doi.org/10.1080/20016689.2020.1829883 |
| _version_ | 1827265408465371136 |
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| author | Craig Coleman Tabassum Salam Amy Duhig Aarti A. Patel Ann Cameron Jennifer Voelker Brahim Bookhart |
| author_facet | Craig Coleman Tabassum Salam Amy Duhig Aarti A. Patel Ann Cameron Jennifer Voelker Brahim Bookhart |
| author_sort | Craig Coleman |
| collection | DOAJ |
| description | Background: Non-medical switching refers to a change in a stable patient’s prescribed medication to a clinically distinct, non-generic, alternative for reasons other than poor clinical response, side-effects or non-adherence. Objective: To assess the perceptions of high-volume Medicare and/or Medicaid physician providers regarding the impact non-medical switching has on their patients’ medication-related outcomes and health-care utilization. Methods: We performed an e-survey of high-volume Medicare and/or Medicaid physicians (spending >50% of their time caring for Medicare and/or Medicaid patients), practicing for >2 years but <30 years post-residency and/or fellowship; working in a general, internal, family medicine or specialist setting; spending ≥40% of their time providing direct care and having received ≥1 request for a non-medical switch in the past 12 months. Physicians were queried on 15-items to assess perceptions regarding the impact non-medical switching on medication-related outcomes and health-care utilization. Results: Three-hundred and fifty physicians were included. Respondents reported they felt non-medical switching, to some degree, increased side-effects (54.0%), medication errors (56.0%) and medication abandonment (60.3%), and ~50% believed it increased patients’ out-of-pocket costs. Few physicians (≤13.4% for each) felt non-medical switching had a positive impact on effectiveness, adherence or patients’ or physicians’ confidence in the quality-of-care provided. Non-office visit and prescriber-pharmacy contact were most frequently thought to increase due to non-medical switching. One-third of physicians felt office visits were very frequently/frequently increased, and ~ 1-in-5 respondents believed laboratory testing and additional medication use very frequently/frequently increased following a non-medical switch. About 1-in-10 physicians felt non-medical switching very frequently/frequently increased the utilization of emergency department or in-hospital care. Conclusion: This study suggests high-volume Medicare and/or Medicaid physician providers perceive multiple negative influences of non-medical switching on medication-related outcomes and health-care utilization. |
| first_indexed | 2024-04-24T14:36:02Z |
| format | Article |
| id | doaj.art-19308e0d74724fe7a37c36f098ceba67 |
| institution | Directory Open Access Journal |
| issn | 2001-6689 |
| language | English |
| last_indexed | 2025-03-22T04:01:29Z |
| publishDate | 2020-01-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Journal of Market Access & Health Policy |
| spelling | doaj.art-19308e0d74724fe7a37c36f098ceba672024-04-28T10:03:33ZengTaylor & Francis GroupJournal of Market Access & Health Policy2001-66892020-01-018110.1080/20016689.2020.18298831829883Impact of non-medical switching of prescription medications on health outcomes: an e-survey of high-volume medicare and medicaid physician providersCraig Coleman0Tabassum Salam1Amy Duhig2Aarti A. Patel3Ann Cameron4Jennifer Voelker5Brahim Bookhart6University of Connecticut School of PharmacyAmerican College of PhysiciansXcendaJanssen Scientific Affairs, LLCXcendaJanssen Scientific Affairs, LLCJanssen Scientific Affairs, LLCBackground: Non-medical switching refers to a change in a stable patient’s prescribed medication to a clinically distinct, non-generic, alternative for reasons other than poor clinical response, side-effects or non-adherence. Objective: To assess the perceptions of high-volume Medicare and/or Medicaid physician providers regarding the impact non-medical switching has on their patients’ medication-related outcomes and health-care utilization. Methods: We performed an e-survey of high-volume Medicare and/or Medicaid physicians (spending >50% of their time caring for Medicare and/or Medicaid patients), practicing for >2 years but <30 years post-residency and/or fellowship; working in a general, internal, family medicine or specialist setting; spending ≥40% of their time providing direct care and having received ≥1 request for a non-medical switch in the past 12 months. Physicians were queried on 15-items to assess perceptions regarding the impact non-medical switching on medication-related outcomes and health-care utilization. Results: Three-hundred and fifty physicians were included. Respondents reported they felt non-medical switching, to some degree, increased side-effects (54.0%), medication errors (56.0%) and medication abandonment (60.3%), and ~50% believed it increased patients’ out-of-pocket costs. Few physicians (≤13.4% for each) felt non-medical switching had a positive impact on effectiveness, adherence or patients’ or physicians’ confidence in the quality-of-care provided. Non-office visit and prescriber-pharmacy contact were most frequently thought to increase due to non-medical switching. One-third of physicians felt office visits were very frequently/frequently increased, and ~ 1-in-5 respondents believed laboratory testing and additional medication use very frequently/frequently increased following a non-medical switch. About 1-in-10 physicians felt non-medical switching very frequently/frequently increased the utilization of emergency department or in-hospital care. Conclusion: This study suggests high-volume Medicare and/or Medicaid physician providers perceive multiple negative influences of non-medical switching on medication-related outcomes and health-care utilization.http://dx.doi.org/10.1080/20016689.2020.1829883non-medical switchingmedicaremedicaidsafety-net providersvulnerable populationsoutcome assessment |
| spellingShingle | Craig Coleman Tabassum Salam Amy Duhig Aarti A. Patel Ann Cameron Jennifer Voelker Brahim Bookhart Impact of non-medical switching of prescription medications on health outcomes: an e-survey of high-volume medicare and medicaid physician providers Journal of Market Access & Health Policy non-medical switching medicare medicaid safety-net providers vulnerable populations outcome assessment |
| title | Impact of non-medical switching of prescription medications on health outcomes: an e-survey of high-volume medicare and medicaid physician providers |
| title_full | Impact of non-medical switching of prescription medications on health outcomes: an e-survey of high-volume medicare and medicaid physician providers |
| title_fullStr | Impact of non-medical switching of prescription medications on health outcomes: an e-survey of high-volume medicare and medicaid physician providers |
| title_full_unstemmed | Impact of non-medical switching of prescription medications on health outcomes: an e-survey of high-volume medicare and medicaid physician providers |
| title_short | Impact of non-medical switching of prescription medications on health outcomes: an e-survey of high-volume medicare and medicaid physician providers |
| title_sort | impact of non medical switching of prescription medications on health outcomes an e survey of high volume medicare and medicaid physician providers |
| topic | non-medical switching medicare medicaid safety-net providers vulnerable populations outcome assessment |
| url | http://dx.doi.org/10.1080/20016689.2020.1829883 |
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