Komen Colorado CEO Speaks Out Against Non-Medical Switching
Susan G. Komen® Colorado CEO Dianne Primavera’s guest commentary “Stop Non-Medical Switching Now” recently appeared in the Broomfield Enterprise and Colorado Politics.
Stop Non-Medical Switching Now
By Dianne Primavera
“Non-medical switching” is a heartbreaking example of when it isn’t. It is the term used to describe how patients, oftentimes with chronic illnesses, are forced by their insurance plan to take less expensive medications that, studies show, are often less effective. It takes medical decision-making out of the hands of doctors and patients. The decisions are made by patients’ insurance companies. Insurance companies are the only winners.
As a breast cancer survivor and the Chief Executive Officer of Susan G. Komen Colorado, I am committed to doing all I can to fight breast cancer and save Coloradans’ lives. Non-medical switching can have a devastating effect on breast cancer patients as it does for all patients who rely on continuous therapies to manage their chronic conditions.
Do the decision-makers at insurance companies know the fear of dying from breast cancer? I do!
Have they seen the horror in their children’s eyes when they told them they had cancer? I have!
Have they experienced the sadness, anxiety, frustration, and anger provoked by a diagnosis of breast cancer? I have!
Have they clung to every word a doctor says about their prognosis and treatment? I have!
As a cancer patient, finding the drug that keeps the cancer at bay is a godsend. Having that drug changed and no longer covered by insurance evokes fears and anxiety about the cancer coming back. It’s hard to imagine that anxiety unless you have walked in a cancer patient’s shoes.
A 2016 study that included a systematic literature review of non-medical switching concludes: “Non-medical switching was more often associated with negative or neutral effects than positive effects on an array of important outcomes. Among patients with stable/well controlled disease, non-medical switching was associated with mostly negative effects.”
Sadly, the negative consequences of using less effective drugs are unpleasant side effects and the recurrence of symptoms. Physicians and health care administrators report that non-medical switching can raise administrative costs and produce poor disease outcomes, resulting in increased emergency room visits, hospitalizations, doctors’ care, and laboratory tests, which, ironically, drive up the cost of health care. Since these consequences can negatively impact the bottom line, I urge insurance companies to look at the full picture.
My battles with cancer motivated my interest in health issues during the eight years I served in Colorado’s House of Representative and chaired the Health and Human Services Committee. I found that Republicans and Democrats demonstrated that protecting and saving lives are not partisan issues. Ending non-medical switching is a needed, important legislative undertaking.
Please urge your Colorado legislators to take action and pass a law that limits insurers’ ability to force you to take a less effective, cheaper drug. The law should ensure that when a patient chooses a health plan because their provider and hospital of choice are in the network, that their prescriptions are covered. A contract is a contract! It should ensure our doctors are the decision-makers and there is a medical reason to change medication.
Patients deserve compassion and empathy. Let’s end unnecessary pain and suffering. Let’s end non-medical switching.
Dianne Primavera was named chief executive of the Denver-based non-profit Susan G. Komen Colorado in April 2017.