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.

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