Every year, many individuals with diabetes are switched from their current diabetes medications and/or medical devices to another due to formulary changes in their health insurance plan. This practice is called non-medical switching (NMS), and it is forced upon patients by someone other than the patient's healthcare team. The purpose of this questionnaire is to obtain information about your experiences with NMS in your healthcare practice during 2017. Please click on the appropriate box(es) to indicate your response to each question.

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* 1. Approximately what percentage of your patients experienced a non-medical switch of their previously prescribed diabetes medications and/or devices?

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* 2. Which medications were affected? (select all that apply)

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* 3. Which diabetes medical devices were affected? (select all that apply)

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* 4. Approximately what percentage of your patients had to pay out-of-pocket because their medication/device was no longer on formulary?

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* 5. Approximately what percentage of your patients had to pay a higher co-pay because their medication/device was moved to a lower tier on formulary?

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* 6. Approximately what percentage of your patients required a pre-authorization and/or had to file an appeal to their insurer to receive their medication/device?

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* 7. Approximately what percentage of your patients experienced delays in receiving their medication/device as a result of non-medical switching?

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* 8. Approximately what percentage of your patients have experienced financial hardship as a result of non-medical switching?

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* 9. Approximately what percentage of your patients experienced an adverse clinical event (e.g., allergic response, increased hypoglycemic or hyperglycemia, ER visit or hospitalization) as result of non-medical switching?

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* 10. On average, what percentage of your work day do you spend addressing issues associated with non-medical switching?

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* 11. Do you believe non-medical switching is in the best interests of your patients?

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* 12. Optional Information: Briefly describe a patient case or clinical situation that exemplifies the adverse effects of non-medical switching on your patients or practice.

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* 13. Thank you for completing this survey. If you would like to receive a summary of the results, please provide your contact information.

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