Examining the prior authorization process, patient outcomes, and the impact of a pharmacy intervention: A single-center review - 21/10/19
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Abstract |
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.
Le texte complet de cet article est disponible en PDF.Key words : drugs, medications, patient outcomes, pharmacy intervention, pharmacy, prior authorization
Abbreviations used : AAD, EHR, FTE, MA, PA, PT, Rx
Plan
| Funding sources: Dr Porter received the American Academy of Dermatology Resident and Fellow Quality Improvement (QI) Project grant for this project. Funding from this grant was for the implementation of the pharmacy intervention, specifically, office supplies and funding to cover travel for Dr Porter to the 2018 American Academy of Dermatology annual meeting to present the QI project at the QI symposium. No funding from the project was used specifically for the research presented in this article. |
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| Conflicts of interest: Dr Flood receives fellowship funding from AbbVie, Janssen, and the National Psoriasis Foundation. Dr Kimball is a consultant and investigator for AbbVie, Bristol-Myers Squibb, Eli Lilly, Janssen, Novartis, Pfizer, and UCB, and receives fellowship funding from AbbVie and Janssen. Dr Porter is a consultant and investigator for AbbVie and Novartis, an investigator for Bristol-Myers Squibb, Eli Lilly, Janssen, and UCB, and has previously received fellowship funding from AbbVie, Janssen, and the National Psoriasis Foundation. Sabrina Popatia, Nicole M. Golbari, Parth V. Patel, and Dr Olbricht have no conflicts of interest to declare. |
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| Reprints not available from the authors. |
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