Patients Pay the Price When Insurers Switch Mental Health Medications

March 9, 2022

More than 53 million American adults live with mental illness, and one in six take prescription medication to treat it. Patients’ disease management and progress, however, are undermined when insurers switch their medication to maximize profits.

That’s the perspective shared in a recent policy brief, “Mental Health Care & Non-Medical Switching,” by clinical psychologist Rimal Bera, MD.

Dr. Bera explains that non-medical switching occurs when insurers push stable patients off the medication they chose with their provider and onto another drug – not for medical reasons, but for insurers’ financial purposes. Given the difficulty of identifying optimal treatments for patients with mental illnesses, and the nature of mental illness, Dr. Bera argues, non-medical is an unacceptable practice for mental health.

Switches Disrupt Treatment, Strain Patients

It can take weeks, even months, to get patients on the right medication at the right dosage.

Yet non-medical switches are often handed down to patients and their providers with little notice. Abrupt changes in medications cause seismic disturbances and present many new challenges for patients:

  • New medications may cause new side effects for patients. It can also make patients feel resentment and a loss of control, which heighten their risk of relapse.
  • Patients already on an effective treatment course may have their gains erased.
  • Non-medical switches to new medications may also increase non-adherence.
  • In patients with severe cases of mental illness, switches can result in volatility, violence against self or others, and hospitalization.

Finally, Dr. Bera explains, non-medical switches can undermine the patient-provider relationship, which is especially critical in fostering trust and shared decision-making.

Short-Sighted Switches Lead to Long-Term Expenses

Insurers think imposing switches on patients will result in cost savings. That might not be the case, Dr. Bera notes.

The brief references a study that found non-medical switches wound up being more expensive to insurers down the road, as patients needed more follow-up visits, laboratory tests and redundant procedures.

How Policymakers Can Help

The burden of non-medical switching is serious for patients with mental illness, the brief concludes. The cost of switches – in terms of lost progress, potential for relapse and damage to relationships with providers – is simply too high. The brief recommends that policymakers prohibit, or at least limit, non-medical switches for patients with mental illness.

To learn more, read Mental Health Care & Non-Medical Switching.

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