Securing prior authorization is a time-consuming and costly process. It burdens the dispensing practice, irritates patients, and could be simplified, according to a consensus of pharmacists.
Securing prior authorization (PA) is a time-consuming, frustrating, and costly process. It burdens the dispensing practice, irritates-even endangers-patients, and could be greatly simplified, if not eliminated, according to a consensus of pharmacists.
"We should be allowed in nearly all cases to take care of the process ourselves rather than contact the physician to have them seek approval," one pharmacist said. "It just makes sense."
Here is how one pharmacist, typical of many respondents, described the prior authorization process:
"First, the call to the insurance company, then you have to call the doctor to have them call the insurance company, then you wait for the doctor to call the insurance company while the patient calls you every hour to check on the progress, then the doctor or the insurance company may or may not call you back to let you know of the progress or outcome. Meanwhile the patient is still calling you every hour."
"Failure to get a PA in a timely manner has often resulted in treatment failure," another pharmacist said.
"It adds unwanted and unneeded stress to people who are being released from the hospital after life-altering procedures, such as a patient whose medications are not covered after a kidney transplant, or a heart attack patient who requires injectable anti-thrombotic medicine," another respondent said.