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 ≥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.

Details

Title
The impact of non-medical switching among ambulatory patients: an updated systematic literature review
Author
Weeda, Erin R 1   VIAFID ORCID Logo  ; Nguyen, Elaine 2 ; Martin, Silas 3 ; Ingham, Michael 3 ; Sobieraj, Diana M 4 ; Bookhart, Brahim K 3 ; Coleman, Craig I 4 

1  The College of Pharmacy, Medical University of South Carolina, Charleston, SC, USA 
2  Department of Pharmacy Practice, Idaho State University College of Pharmacy, Boise, ID, USA 
3  Real World Value & Evidence, Janssen Scientific Affairs, LLC, Titusville, NJ, USA 
4  University of Connecticut School of Pharmacy, Storrs, CT, USA 
Publication year
2019
Publication date
Dec 2019
Publisher
Taylor & Francis Ltd.
e-ISSN
20016689
Source type
Scholarly Journal
Language of publication
English
DOI
https://doi.org/10.1080/20016689.2019.1678563
ProQuest document ID
2358709972
Copyright
© 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. This work is licensed under the Creative Commons  Attribution – Non-Commercial License http://creativecommons.org/licenses/by-nc/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.