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As if consumers needed an additional reason for disliking health-insurance companies, a report from the National Consumers League (NCL) suggests some are getting one in the form of “therapeutic substitution.” The term applies to a phenomenon in which a consumer is given “an alternative to a prescribed medication that is not chemically or generically equivalent but is in the same therapeutic class and is used to treat the same condition.”

The report says insurance companies initiate such substitution — with or without consulting the consumer or the consumer’s doctor beforehand — as a cost-saving measure.

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