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Look out for so-called "generic alternatives." During the past few months, health insurance plans have been sending letters to their members urging them to switch from brand name medications to so-called "generic alternatives." |
News
Consumer Federation Issues Consumer Alert: Warns Against Misleading Prescription Drug Switching Practice
December 1, 2008
TALLAHASSEE- The misleading and potentially dangerous practice known as prescription drug "switching" is becoming more prevalent in Florida, according to a consumer alert issued today by the Consumer Federation of the Southeast.
During the past few months, health insurance plans have been sending letters to their members urging them to switch from brand name medications to so-called "generic alternatives."
The Federation wants patients to know a generic alternative, or "therapeutic substitution" is not the same as a "therapeutic equivalent".
"The concept of therapeutic substitution, or 'switching,' can be very confusing for consumers," said Federation director Walter Dartland. "Most people don't understand the terminology and don't realize the insurance companies are encouraging them to switch to a completely different drug that often has a different chemical make up and which can affect their body very differently than the medication they currently use."
"There are certain drug classes where it may be safe to switch from one drug to another, and there are others where switching can be dangerous - and the person deciding that should be the patient's physician," said Dr. Bruce Rubin, assistant professor of clinical Neurology at the University of Miami's Miller School of Medicine. "I do not appreciate HMOs and insurance companies, who are not privy to my patient's medical history, sending letters asking them to switch medications. It undermines the doctor-patient relationship by questioning my credibility as their physician."
Responding to the growing practice, the Consumer Federation of the Southeast today unveiled steps patients can take to protect themselves:
- Start with your doctor. Discuss your current medication and treatment plans with your doctor. Pay close attention to the medications you're currently prescribed and keep a written record of what drugs your doctor feels are best for your condition.
- Check with your insurance company. Since it's possible your insurance company might practice incentivized therapeutic substitution with or without obtaining your consent, or that of your doctor, call your insurer and ask.
- Ask questions. If your insurance plan, pharmacist or doctor wants to switch your medication, ask why - especially if your current prescription appears to be doing its job. It's critical to know if the new medication will achieve better results because there might be unexpected side effects, as well as interactions with other drugs or food. Ask whether you need to take the drug with the same frequency as your current prescription.
- Appeal. If your insurance company is pushing for a new drug but your physician feels your current prescription is the safest and most effective for you, appeal the insurance company's action. Call your insurance carrier for information on its appeal process.
Dartland emphasized switching medications for financial gain is unethical and dangerous - putting patient safety at risk and eroding the doctor/patient relationship.
"When it comes to their health," he said, "patients deserve all the facts."
The Consumer Federation of the Southeast (CFSE) is a not-for-profit consumer advocacy group founded in 2003 and dedicated to consumer advocacy in the Southeastern United States. Our goal is to establish a vigorous, new, pro-consumer agenda built upon public awareness, consumer education, and coalition-building. Consumers need to know someone is looking out for their well-being. For more information visit http://www.consumerfederationse.com.
Background Information
BlueCross BlueShield: Step Therapy
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BlueCross BlueShield: Generic Alternatives
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Humana: Pay for Performance
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Medco: Generic Alternatives
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VIDEO: CONSUMER ALERT |
Share Your StoryKnow Your Rights: Get Informed The rising cost of healthcare has prompted many insurance companies to practice what is called 'incentivized therapeutic substitution' or 'therapeutic switching.' this cost-cutting strategy involves replacing your prescription medication with a different medication - which is often chemically different. It has nothing to do with better health care and everything to do with increasing profits. Watch this video, then join our forum to speak out about your experiences. Share your story. |
Links to Consumer Sites |