Center for Digestive Disorders, Boston Medical Center, Boston, Massachusetts.
Section of Gastroenterology, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts.
Inflamm Bowel Dis. 2019 Sep 18;25(10):1621-1628. doi: 10.1093/ibd/izz013.
In an effort to manage health care costs and avoid improper medication use, prior authorizations (PAs) have become a standard stipulation required by payers in the determination of medication coverage. For gastroenterologists managing patients, especially those with inflammatory bowel disease (IBD), the PA process is time-consuming and further complicated by 2 additional factors: step therapy requirements and failure of payers to recognize updated IBD treatment pathways. These factors often lead to PA denials and cause treatment delays, which in turn can lead to disease progression, ongoing patient suffering, and ultimately an increase in both direct and indirect total costs. In this manuscript, the PA process, PA models, tips and available resources to navigate the PA process, and future advocacy efforts are discussed with the intent to help gastroenterology practices optimize PA outcomes and improve the care provided to patients with IBD and other gastrointestinal disorders.
为了控制医疗保健成本并避免不当用药,事先授权(PA)已成为支付方确定药物覆盖范围的标准规定。对于管理患者的肠胃病学家来说,特别是那些患有炎症性肠病(IBD)的患者,PA 流程耗时且由于以下两个额外因素而进一步复杂化:逐步治疗要求以及支付方未能认识到更新的 IBD 治疗途径。这些因素常常导致 PA 被拒绝,并导致治疗延误,这反过来又会导致疾病进展、持续的患者痛苦,最终导致直接和间接总成本的增加。在本文中,讨论了 PA 流程、PA 模型、应对 PA 流程的技巧和可用资源,以及未来的倡导工作,旨在帮助肠胃病学实践优化 PA 结果并改善对 IBD 和其他胃肠道疾病患者的护理。