The impact of non-medical switching among ambulatory patients: an updated systematic literature review

Background: Non-medical switching (NMS) is defined as switching to a clinically similar but chemically distinct medication for reasons apart from lack of effectiveness, tolerability or adherence. Objective: To update a prior systematic review evaluating the impact of NMS on outcomes. Data sources: A...

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Main Authors: Erin R. Weeda, Elaine Nguyen, Silas Martin, Michael Ingham, Diana M. Sobieraj, Brahim K. Bookhart, Craig I. Coleman
Format: Article
Language:English
Published: MDPI AG 2019-01-01
Series:Journal of Market Access & Health Policy
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Online Access:http://dx.doi.org/10.1080/20016689.2019.1678563
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author Erin R. Weeda
Elaine Nguyen
Silas Martin
Michael Ingham
Diana M. Sobieraj
Brahim K. Bookhart
Craig I. Coleman
author_facet Erin R. Weeda
Elaine Nguyen
Silas Martin
Michael Ingham
Diana M. Sobieraj
Brahim K. Bookhart
Craig I. Coleman
author_sort Erin R. Weeda
collection DOAJ
description Background: Non-medical switching (NMS) is defined as switching to a clinically similar but chemically distinct medication for reasons apart from lack of effectiveness, tolerability or adherence. Objective: To update a prior systematic review evaluating the impact of NMS on outcomes. Data sources: An updated search through 10/1/2018 in Medline and Web of Science was performed. Study selection: We included studies evaluating ≥25 patients and measuring the impact of NMS of drugs on ≥1 endpoint. Data extraction: The direction of association between NMS and endpoints was classified as negative, positive or neutral. Data synthesis: Thirty-eight studies contributed 154 endpoints. The direction of association was negative (n = 48; 31.2%) or neutral (n = 91; 59.1%) more often than it was positive (n = 15; 9.7%). Stratified by endpoint type, NMS was associated with a negative impact on clinical, economic, health-care utilization and medication-taking behavior in 26.9%,41.7%,30.3% and 75.0% of cases; with a positive effect seen in 3.0% (resource utilization) to 14.0% (clinical) of endpoints. Of the 92 endpoints from studies performed by the entity dictating the NMS, 88.0%were neutral or positive; whereas, only 40.3%of endpoints from studies conducted separately from the interested entity were neutral or positive. Conclusions: NMS was commonly associated with negative or neutral endpoints and was seldom associated with positive ones.
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spelling doaj-art-5fc31731938240c2a82c96d93a07b6b22025-08-20T01:57:31ZengMDPI AGJournal of Market Access & Health Policy2001-66892019-01-017110.1080/20016689.2019.16785631678563The impact of non-medical switching among ambulatory patients: an updated systematic literature reviewErin R. Weeda0Elaine Nguyen1Silas Martin2Michael Ingham3Diana M. Sobieraj4Brahim K. Bookhart5Craig I. Coleman6Medical University of South CarolinaIdaho State University College of PharmacyLLCLLCUniversity of Connecticut School of PharmacyLLCUniversity of Connecticut School of PharmacyBackground: Non-medical switching (NMS) is defined as switching to a clinically similar but chemically distinct medication for reasons apart from lack of effectiveness, tolerability or adherence. Objective: To update a prior systematic review evaluating the impact of NMS on outcomes. Data sources: An updated search through 10/1/2018 in Medline and Web of Science was performed. Study selection: We included studies evaluating ≥25 patients and measuring the impact of NMS of drugs on ≥1 endpoint. Data extraction: The direction of association between NMS and endpoints was classified as negative, positive or neutral. Data synthesis: Thirty-eight studies contributed 154 endpoints. The direction of association was negative (n = 48; 31.2%) or neutral (n = 91; 59.1%) more often than it was positive (n = 15; 9.7%). Stratified by endpoint type, NMS was associated with a negative impact on clinical, economic, health-care utilization and medication-taking behavior in 26.9%,41.7%,30.3% and 75.0% of cases; with a positive effect seen in 3.0% (resource utilization) to 14.0% (clinical) of endpoints. Of the 92 endpoints from studies performed by the entity dictating the NMS, 88.0%were neutral or positive; whereas, only 40.3%of endpoints from studies conducted separately from the interested entity were neutral or positive. Conclusions: NMS was commonly associated with negative or neutral endpoints and was seldom associated with positive ones.http://dx.doi.org/10.1080/20016689.2019.1678563managed carenon-medical switchoutcome assessmenttherapeutic interchange
spellingShingle Erin R. Weeda
Elaine Nguyen
Silas Martin
Michael Ingham
Diana M. Sobieraj
Brahim K. Bookhart
Craig I. Coleman
The impact of non-medical switching among ambulatory patients: an updated systematic literature review
Journal of Market Access & Health Policy
managed care
non-medical switch
outcome assessment
therapeutic interchange
title The impact of non-medical switching among ambulatory patients: an updated systematic literature review
title_full The impact of non-medical switching among ambulatory patients: an updated systematic literature review
title_fullStr The impact of non-medical switching among ambulatory patients: an updated systematic literature review
title_full_unstemmed The impact of non-medical switching among ambulatory patients: an updated systematic literature review
title_short The impact of non-medical switching among ambulatory patients: an updated systematic literature review
title_sort impact of non medical switching among ambulatory patients an updated systematic literature review
topic managed care
non-medical switch
outcome assessment
therapeutic interchange
url http://dx.doi.org/10.1080/20016689.2019.1678563
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