Non-Medical Switching
Non-medical switching is a strategy that health plans use to control costs and maximize profits by forcing stable patients to switch from current and effective treatments to drugs that may not be as effective for reasons unrelated to health.
AiDeclaración de posición sobre la artritis respecto al cambio de tratamiento por motivos no médicos.
Position Statement: AiArthritis opposes forcing stable patients to switch from effective treatments to those which may or may not be as effective, for economic reasons unrelated to health- such as insurer profit. We support legislation that limits this practice, and believe treatment decisions should remain between the patient and physician.
Patient Written Glossary of Terms
Frequently, everyday terms when navigating a diagnosis of an AiArthritis Disease—such as "payer"—can lead to confusion. Therefore, we have developed a glossary to assist!
Descubra los recorridos de los pacientes con Cambio de tratamiento no médico ¡En nuestra videoteca!
The Patient-Instructed Video Library
The Patient-Instructed Video Library was created to help our community gain a deeper understanding of critical issues that affect access to health care. The goals of this initiative are to educate, inspire fellow patients to share their experiences, and empower our community to take action in addressing access-related challenges.
What is Non-Medical Switching? (Michael's Perspective)
Michael, a Volunteer Program Coordinator for AiArthritis and a Psoriatic Arthritis patient, explains non-medical switching. This happens when insurers or pharmacies change your medication or dosage without your doctor’s input to save costs. Such changes can disrupt treatment, making it essential to understand non-medical switching. Watch the next video to learn more about its significance.
Non-Medical Switching - Why Should Patients Care? (Michael's Perspective)
Michael discusses the effects of non-medical switching for those with AiArthritis. Insurance companies may switch to a biosimilar for cost savings without consulting your doctor, potentially disrupting treatment and rendering the original drug ineffective upon resuming. He emphasizes the importance of staying informed and communicating with your doctor about any changes.
Non-Medical Switching - Why Should Patients Care? (Ray's Perspective)
Ray, a patient advocate with psoriatic arthritis, emphasizes the effects of non-medical switching on treatment. While doctors adjust medications based on history, insurers prioritize cost savings. Switching small molecule drugs may be manageable, but changing biologics is more complex for autoimmune patients. He argues treatment decisions should rest with patients and doctors, highlighting legislation to protect against profit-driven non-medical switching.
Historia de una paciente que cambió de tratamiento por motivos no médicos: la perspectiva de Deb
Deb, voluntaria de AiArthritis y persona que vive con artritis reumatoide, comparte su experiencia con el cambio de medicación sin indicación médica. Tras comenzar un nuevo tratamiento, Deb descubrió que le habían cambiado a un biosimilar sin su conocimiento. Deb recalca la importancia de la transparencia y de estar informada sobre los medicamentos que se le administran. Si bien Deb no está en contra de los biosimilares, cree que los pacientes deben ser debidamente notificados sobre los cambios en su tratamiento.
Historia de una paciente que cambió de tratamiento por motivos no médicos: la perspectiva de Lisa
Lisa, voluntaria con artritis reumatoide, comparte su experiencia tras un cambio de seguro médico. Tras un tratamiento estable con Enbrel, su aseguradora intentó cambiarla a un biosimilar de Humira que ya le había provocado una reacción alérgica. Enfatiza la importancia de la participación del paciente en las decisiones sobre el tratamiento y advierte que los cambios sin la opinión de su reumatólogo pueden poner en riesgo su atención médica. Lisa aboga por una mejor comunicación y un mayor apoyo para el acceso a medicamentos eficaces.
Non-Medical Switching Patient Story: Leila's Perspective
Leila, Health Education Manager at AiArthritis and a lupus and Sjögren's disease patient, shares her experience with non-medical switching. After ten years on Benlysta, insurance changes forced her back to subcutaneous injections, affecting her quality of life. She highlights the need for clear communication and patient advocacy, urging that patients be informed and supported during treatment.
Learn More By Exploring Our Video Library
Did you know that access to healthcare and treatments is frequently tied to policies like government healthcare systems and insurance companies? Recognizing these influences and sharing YOUR experiences with legislators to illustrate the need for policy change is crucial!
Share Your Non-Medical Switching Experience
Would you share your experience with us? We’d like to hear how you navigated challenges in obtaining healthcare or treatments. What obstacles did you face, and how have they shaped your journey? Your insights could be invaluable to others in similar situations.
¡Comienza la clase!Cambio de tratamiento no médico
About The Classroom: Lead instructors, including our CEO Tiffany, who has non-radiographic axial spondyloarthritis (nr-axSpA) and is a former award-winning college instructor, will collaborate with Class Discussion Leaders living with our diseases to host engaging webinars and AiArthritis Voices 360 Talk Show segments.
Non-Medical Switching (NMS) Non-medical switching is a strategy that health insurers use to control their costs and maximize profits by forcing stable patients to switch from their current, effective medications to drugs that may not be as effective, for reasons unrelated to health.
How To Get More Involved!
Ready to deepen your involvement? Share experiences to support our fight for change with AiArthritis—join us for co-writing letters, virtual Field Trips, or become an inaugural AiAdvocate in our policy leadership program!
Patient Education - Legislator Education Sheet
Hay disponible un PDF descargable sobre el cambio de proveedor no médico.
Join the Knowledge = Empowerment Program
A virtual, patient-led classroom approach designed to help patients understand legislative issues affecting treatment access and connect them with opportunities to advocate for change.
#WTHellth?!
Share your frustrations with the healthcare system using #WTHellth. Prefer privacy? Submit a written rant anonymously through AiArthritis’ RANT! program, selecting the #WTHellth category.