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Prior Authorizations: A Necessary Evil?
Timothy E Wilens1, Kai Wilens2, K Yvonne Woodworth3
1Massachusetts General Hospital, Boston; Harvard Medical School, Boston, Massachusetts.
Summary
Child and adolescent psychiatrists face significant burdens completing prior authorizations (PAs) for medications. These requirements impact treatment initiation and continuation, often focusing on cost-effectiveness and prescribing patterns.
Area of Science:
- Psychiatry
- Health Policy
Background:
- Child and adolescent psychiatrists (CAPs) commonly encounter prior authorization (PA) requirements for prescribed medications.
- PA processes are often mandated for both brand and generic drugs, necessitating justification for medical necessity, dosage, and cost-effectiveness compared to alternatives.
Discussion:
- Some states utilize PAs to regulate prescribing patterns, particularly for antipsychotics in children.
- These regulations have been linked to reduced antipsychotic use in children aged 6-12.
Key Insights:
- Prior authorizations represent a substantial administrative burden for child and adolescent psychiatrists.
- PA policies can influence clinical decision-making and medication access for pediatric patients.
- State-level regulations, such as those for antipsychotics, demonstrate the impact of PAs on prescribing trends.
Outlook:
- Further research is needed to evaluate the long-term impact of PA policies on pediatric mental healthcare.
- Exploring streamlined PA processes could alleviate physician burden and improve timely access to necessary medications.
- Investigating alternative strategies for medication cost management and utilization review is warranted.
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