The study reveals that prior authorization is an obstacle to cancer treatment

80% of oncologists surveyed reported that prior authorization had a negative impact on patients’ outcomes.

Participating oncologists say standardized forms and new technologies will reduce the challenges posed by previous permits. Photo: Shutterstock.

In the United States, prior authorization is used to reduce medical costs that are unnecessary, but oncologists say they hinder the care of cancer patients.

A new study found that nearly 90% of oncologists involved say prior authorization is a major barrier to considering starting a patient with a new drug.

In addition, because of the time it takes to deal with bureaucracy, 70% of oncologists say they have full-time staff whose role is to deal with prior authorizations and other benefits.

“Our study shows that steps such as prior authorization not only delay the treatment time of one-third of patients by more than 7 days, but these delays also negatively affect their patients’ clinical outcomes,” said Josh Marsh, Cardinal’s chief operating officer. . Sonexus Access and Patient Care Health, in a statement. “This is especially true for more complex therapies, such as CAR T-cell therapy.”

He noted that oncologists mentioned the slow approval processes from of payers as the most challenging problem in CAR-T bypass process“.

The study was commissioned by Cardinal Health, a Ohio-based company which is a pharmaceutical distributor, manufacturer and worldwide distributor of medical and laboratory products, and performance solution provider d data on care centers doctor.

A report on the results of the study appears in Oncology Insights, a series of research-based reports published by Cardinal Health that are designed to help physicians, pharmaceutical companies, payers and other stakeholders understand trends and changes in specialist medicine.

The results of this study, which specifically asked oncologists, reflect findings from two other studies recently published, which was surveyed doctors in various therapeutic fields.

In March, a survey by the Association for the Management of Medical Groups, which included responses from leaders representing more than 400 group practices, found that 79% of respondents felt that prior authorization requirements had increased over the past 12 months.

A minority, 19%, said there was no change, and only 2% said those requirements had decreased.

In December 2021, a study by the American Medical Association found that one-third of physicians reported that prior authorization caused a delay that resulted in at least one patient having a serious problem, such as hospitalization, childbirth, disability, and disability. and even death.

In addition, more than 80% of physicians say that patients sometimes abandon recommended treatment due to barriers to prior authorization, and more than half of respondents treating elderly patients say that prior authorization has hindered patients’ ability to do their job.

Significant barrier. Federal policy support

This last study among oncologists was conducted from March to April 2022. In this study, 170 participants from hospital and community practices were consulted.

The study examines how much resources oncology practices allocate to administrative tasks and how oncologists view a variety of solutions, including technology, federal mandates, and pharmaceutically supported patient care programs.

The vast majority of oncologists said previous authorizations were a major barrier to considering starting a new drug and had negative effects on patients’ outcomes.

For those patients whose treatment requires prior permission, 21% of oncologists say it always delays care, while 39% say it often causes delays in necessary care.

Participating oncologists also said that standardized forms (31%) and new technologies (30%) would help significantly reduce the challenges posed by previous permits; a smaller percentage believe that standardized response times from managed care organizations (16%) and greater clarity on the appeal process (7%) would also be useful.

“While standardized forms are unlikely to be introduced, given the complexity of today’s healthcare cost landscape, pre-authorization technology solutions have been shown to reduce delays by 25% by helping patients start treatment before.” said Marsh in a statement.

He was hopeful for the future: “As technology continues to evolve, we hope to see a reduction in the negative effects of these delays in patient care.”

More than 7 out of 10 participating oncologists said they would support federal policies that streamline the pre-authorization process, and two-thirds said drug-sponsored programs are valuable in helping patients overcome previous permits and other barriers to access.

However, when asked about drug-sponsored patient access programs for the therapies they prescribe, only one-third reported that most prescription therapies have patient access programs / services, while 50% say that “ some “have them.

But 10% of oncologists said few were available, and 7% said they were unsure if programs were available.

Source consulted here.