%0 Journal Article
%T The impact of non-medical switching among ambulatory patients: an updated systematic literature review
%A Brahim K. Bookhart
%A Craig I. Coleman
%A Diana M. Sobieraj
%A Elaine Nguyen
%A Erin R. Weeda
%A Michael Ingham
%A Silas Martin
%J Journal of Market Access & Health Policy
%D 2019
%R https://doi.org/10.1080/20016689.2019.1678563
%X ABSTRACT 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 ¡Ý25 patients and measuring the impact of NMS of drugs on ¡Ý1 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
%U https://www.tandfonline.com/doi/full/10.1080/20016689.2019.1678563