Background/Purpose: Health insurance plan designs often have benefits that result in highly prescriptive patient (pt) treatment options that can result in switching of patient’s medications for non-medical (economic) reasons.

Methods: An online pt survey was conducted in pts recruited from advocacy organizations (Global Healthy Living Foundation, National Psoriasis Foundation) and a research panel (Research Now). Pts were eligible if they were ≥18 years of age, resided in United States; had a diagnosis for one of the following: rheumatoid arthritis, Crohn’s disease, ulcerative colitis, psoriasis or psoriatic arthritis; were currently taking a biologic; and consented to participate. Pts who met these criteria answered follow up questions about their experiences related to a possible non-medical switch (NMS) of their biologic medication. Descriptive statistics (n%, mean, SD) were used to summarize responses.

Results: A total of 1,696 pts completed the 20-minute survey; 993 were from advocacy groups and 703 from a research panel. Of the 1,696 patients that were asked about their perceptions to a possible biologic NMS, 90% expressed that they wouldn’t want to switch biologics if their current medication was helping my disease. 71% indicated they would not risk switching to another biologic. Only 29% would switch if the new biologic was cheaper. 86% of patients expressed concern that switching may cause more side effects, and 81% worried that switching would increase their stress. 74% were concerned that switching would cause them to lose their copay support. 20% (n=337) of patients had received notification their biologic insurance coverage was changing and they should consider switching biologics to avoid paying a higher cost. Of these, 79% took at least one action to avoid a NMS, most often asking their doctors’ offices to appeal the switch; 56% did not make the switch. Of pts that agreed to a NMS (n= 150), 67% did so to avoid paying a higher cost for their current biologic medication; most often pts switched to a biologic with the same mode of administration. Additionally, of patients that reported a NMS, 67% indicated that the biologic they were previously taking worked well for them, and 70% didn’t want to switch to another biologic. More than half (56%) went without therapy for administrative reasons during the period of transition from the old biologic to the NMS treatment.

Conclusion: Pts reported multiple concerns about NMS that would impact treatment outcomes, and many of the pts who non-medically switched in this survey missed treatments. Future studies should be conducted on real world pt experience with NMS to understand the impact on treatment persistency and pt outcomes.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/patients-experiences-and-attitudes-about-non-medical-switching-of-biologics-results-from-an-online-patient-survey/