In a recently released health care analytics brief, the Institute for Patient Access (IfPA) has found that patients with chronic diseases who switch medications for financial—rather than medical—reasons experience poorer outcomes. Moreover, patients with rheumatoid arthritis (RA) who had been switched to alternate therapy for non-medical reasons had Medicare payments that increased the following year. 

These findings suggest that there may be both medical and financial value to maintaining treatment course in patients already stable on current medications.

High Yield Data Summary

  • Patients who switched medications once were more likely to have their treatment interrupted by a second switch, with a higher rate of second switches for patients with RA

Using Medicare 5% Standard Analytical Files from 2011-2014, the IfPA examined data for patients with RA, Crohn’s disease, or immunodeficiency, focusing on both patient use of medications and biologics covered by Medicare Part B and Medicare spending before and after the non-medical switch. 

Continue Reading

Non-medical switching was defined as “compelling a stable patient to change medications for reasons unrelated to his or her health; often driven by health plan design or policies”.

Data released by the IfPA suggest that patients with RA who switched to a less expensive medication experienced increased Medicare payments; for patients with no gap in therapy and 1 medication switch, payment increased by $8711.52, while patients with no gap in therapy and 2 medication switches saw their payments increased by $8827.32.

Conversely, patients with RA who remained on the same treatment for 271 days or more saw a yearly Medicare payment increase of only $201.24.

The IfPA also found that patients who switched medications once were more likely to have their treatment interrupted by a second switch over the course of the 2-year study, with higher rates of second switches for patients with RA.

“Further research is needed to more fully understand cost-motivated switches and their consequences,” the researchers noted in a press release. “Health plans should approach issues of non-medical switching with caution, recognizing that switching the medicines of stable patients may impact patients’ course of care and result in higher costs.”

Related Articles


Cost-motivated switching study reinforces patients’ concerns [press release]. Washington, D.C.: Institute for Patient Access. Published October 13, 2016. Accessed October 14, 2016. 

follow @RheumAdvisor