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Examining the prior authorization process, patient outcomes, and the impact of a pharmacy intervention: A
Sabrina Popatia1, Kelsey S Flood2, Nicole M Golbari3
1Baylor College of Medicine, Houston, Texas.
Background:
Dermatology experiences a disproportionately high burden of prior authorizations (PAs).
Objective:
To examine the effect of a centralized pharmacy intervention on the PA process and the impact of PAs on patient outcomes.
Methods:
A retrospective review of PAs submitted for medications before and after implementation of pharmacy intervention was conducted.
Results:
PA was required for 8.1% of all prescriptions. PAs were most frequently submitted for topical steroids, topical antibiotics and antifungals, and topical retinoids. Most common indications included acne, psoriasis, and dermatitis. Biologic agents (55.2%) and brand-name only medications (42.8%) required PA at higher rates. Pharmacy intervention resulted in shorter time to PA submission (4 days vs 1 day, P < .001) and decision (6 days vs 1 day, P < .001) and higher approval rates (63.9% vs 80.6%, P < .001) but did not decrease the total number of PAs. Patients with approved PAs had higher likelihood of disease improvement vs those with denied PAs (71.1% vs 58.0%, P = .013).
Limitations:
Data were collected from a single academic institution. Patient medication compliance was not assessed.
Conclusions:
The current PA process may result in delays in care and a negative impact on patients. A centralized pharmacy intervention is an effective measure but does not eliminate the overall burden of PAs.
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