What Is Non-Medical Switching?

Non-medical switching occurs when patients have been “switched” to a new medication without their consent or the consent of their doctor. In general, non-medical switching forces patients to be switched into generic or brand medication based on cost, and without patient or physician approval.

Why Medication Stability Matters

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Patients with chronic health disease and their health care providers often go through a long period of trial and error to find the right prescription medicine and dosage to give the patient a stable health outcome, a predictable
reatment regimen and improved quality of life.

Switching medications for reasons not related to the patient’s best care can compromise the patient’s health and
rive up health care costs for both the patient and for society.

Share Your Story About Non-Medical Switching

What You Can Do About Non-Medical Switching

The Mi Medication Stability Coalition invites patients, physicians and other health providers to share your non-medical switching story with us.

Your story matters and will help draw attention to this practice that many people don’t know about.

Share Your Story

Patients

Your story will highlight the impact on non-medical switching on patients like you, on families like yours. Patients, share your story here.

Doctors and Health Care Providers

And, if you are a health care provider—tell us stories about the effects of non-medical switching on your patients. Doctors and health care providers, share your story here.

Learn How to File a Grievance or a Complaint

Learn How to File a Grievance or a Complaint

The State of Michigan’s Department of Insurance and Financial Services (DIFS) has created an informational video, a power point, and a brochure to educate you on how to resolve a grievance with your health plan or insurance company, including grievances related to your prescription medicine coverage––and, if you are still not satisfied, how to file a complaint with DIFS. While there is no guarantee that you will get the result you seek, you will put yourself in a better position if you follow the process.

Frequently Asked Questions

What is non-medical switching?

Non-medical switching occurs when patients have been “switched” to a new medication without their consent or the consent of their doctor.

In general, non-medical switching forces patients to be switched to a generic or brand medication, usually based on cost, and without patient or physician approval. Switching can occur in the middle of an insurance year, even if a patient has picked that insurance because of its prescription coverage.

One of the many problems with non-medical switching is that it interrupts the physician-patient relationship and their history together. Patients with chronic health disease and their health care providers go through a long period of trial and error to find the right prescription medication and dosage that provides the patient with a stable health outcome, a predictable health regimen, and an improved quality of life. But non-medical switching compromises the patient’s health, drives up the patient’s cost, and, increases costs to society.

Why does non-medical switching occur?

Non-medical switching occurs for reasons usually unrelated to health. This switch is more often than not driven by health insurance plan design or policies to ensure that the insurance plan saves money.

What are some examples of non-medical switching?

Examples of non-medical switching include:

  • Removing the patient’s drug coverage from their formulary plan
  • Increasing the patient’s out-of-pocket costs to stay with the drug that is working
  • Moving drug treatments to prohibitively priced tiers
  • Creating dosage and refill restrictions that limit the patient’s dosage that have been proven by the patient to work.
I think I may have been switched. What can I do?

First, learn about the process. The State of Michigan’s Department of Insurance and Financial Services (DIFS) has created an informational video, a powerpoint, and a brochure to educate you on how to resolve a grievance with your health plan or insurance company, including grievances related to your prescription medicine coverage––and, if you are still not satisfied, how to file a complaint with DIFS. While there is no guarantee that you will get the result you seek, you will put yourself in a better position if you follow the process.

Read the DIFS Brochure Guide to Resolving Health Insurance Problems (PDF)

Videos

Protecting Patients from Non-Medical Switching Video
https://www.youtube.com/watch?v=TzGD8gUqw-c

Understanding Non-Medical Switching Video
https://www.youtube.com/watch?v=2I67kYOh_sk

Who We Are

The Michigan (Mi) Medical Stability Coalition supports patients’ right to stable health through the use of physician directed prescription drugs.

The Mi Medical Stability Coalition seeks to educate and support the public and policy makers about the importance of medication stability, and to support actions that encourage medication stability.

Coalition Partners

American Autoimmune Related Diseases Association, Inc.
https://www.aarda.org

American Cancer Society Cancer Action Network
https://www.acscan.org

Asthma and Allergy Foundation of America—Michigan Chapter
www.aafamich.org

The Coalition of State Rheumatology Organizations (CSRO)
http://csro.info/home.aspx

Epilepsy Foundation of Michigan
www.epilepsymichigan.org

HAAM and UNIFIED - HIV Health and Beyond
http://www.miunified.org

Mental Health Association in Michigan
http://www.mha-mi.com

Michigan Academy of Family Physicians
https://www.mafp.com

Michigan Disability Rights Coalition
http://mymdrc.org

Michigan Protection and Advocacy Service
http://www.mpas.org

Michigan Rheumatism Society
http://mirheumatism.org

Michigan Society of Hematology and Oncology
http://www.msho.org/aws/MSHO/pt/sp/home_page

National Alliance on Mental Illness Michigan
http://namimi.org

National Multiple Sclerosis Society
http://www.nationalmssociety.org

U.S. Pain Foundation
https://www.uspainfoundation.org