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
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
Doctors and Health Care Providers
Learn How to File a Grievance or a Complaint
Learn How to File a Grievance or a Complaint
Frequently Asked Questions
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.
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.
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.
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)
DIFS Department of Insurance and Financial Services
Medicaid Fair Hearings—Michigan Administrative Hearing System
Know Your Health Insurance Rights
Brochures, Flyers, Forms, and Power Points
Non-Medical Switching in Michigan
DIFS Brochure — Guide to Resolving Health Insurance Problems (PDF)
DIFS Grievance Form — Health Care-Request for External Review
DIFS Powerpoint — What To Do When Things Go Wrong
The Impact of Cost-Motivated Switching
The True Cost of Non-Medical Switching
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.
American Autoimmune Related Diseases Association, Inc.
American Cancer Society Cancer Action Network
Asthma and Allergy Foundation of America—Michigan Chapter
The Coalition of State Rheumatology Organizations (CSRO)
Epilepsy Foundation of Michigan
HIV/AIDS Alliance of Michigan, and MI Unified
Mental Health Association in Michigan
Michigan Academy of Family Physicians
Michigan Disability Rights Coalition
Michigan Protection and Advocacy Service
Michigan Rheumatism Society
Michigan Society of Hematology and Oncology
National Alliance on Mental Illness Michigan
National Multiple Sclerosis Society
U.S. Pain Foundation