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Related Experiment Video

Updated: Jun 22, 2025

Author Spotlight: Overcoming Anti-VEGF Resistance Through Advanced Vascular Morphology Assessment in Choroidal Neovascularization
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Anti-VEGF Pharmaceutical Prior Authorization in Retina Practices.

Sabin Dang1, D Wilkin Parke2, Guneet S Sodhi2

  • 1The Retina Institute, St Louis, Missouri.

JAMA Ophthalmology
|June 27, 2024
PubMed
Summary

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REPLY.

Ophthalmology·2026
This summary is machine-generated.

Prior authorization for anti-vascular endothelial growth factor (VEGF) injections is frequently approved but often delays patient care. Streamlining or eliminating this process for certain cases could improve efficiency and patient outcomes.

Area of Science:

  • Ophthalmology
  • Health Services Research
  • Health Economics

Background:

  • Anti-vascular endothelial growth factor (VEGF) injections are crucial for treating retinal diseases.
  • Prior authorization (PA) is a common administrative hurdle for these treatments.
  • The necessity of PA for accurate anti-VEGF use warrants reevaluation.

Purpose of the Study:

  • To quantify prior authorization (PA) approval rates for anti-VEGF medications (aflibercept, ranibizumab, bevacizumab).
  • To determine the administrative burden associated with PA in retina practices.
  • To assess the impact of PA on patient care delays.

Main Methods:

  • Prospective multicenter quality improvement study.
  • Data collected from 9 private US retina practices (January-June 2022).

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  • Analysis of 2,225 prior authorization requests for anti-VEGF medications.

    • Main Results:

    • 96.2% of PA requests were approved.
    • Reauthorization was the most common reason for PA (64%).
    • 59.6% of approvals resulted in care delays exceeding 24 hours; median staff time per PA was 100 minutes.

    Conclusions:

    • Despite high approval rates, PA for anti-VEGF injections frequently delays patient care.
    • The current PA process may be inefficient for retina specialists.
    • Consideration should be given to eliminating PA for bevacizumab and reauthorizations for established patients.