Prior Auth Erodes Trust, Costs More

Dr. Mark Lewis witnessed the agony of a patient with a metastasized gastrointestinal tumor. He urgently requested an opioid prescription to alleviate the patient’s pain, but the insurer required prior authorization. Despite no communication or red flags, the patient left the pharmacy empty-handed, ending up in the ER in excruciating pain. Such delays can harm patients and lead to higher costs. Dr. Lewis expressed frustration at the disconnect between the necessity of treatments and the time spent waiting for prior authorization. This issue is not limited to opioids, as even standard chemotherapy often requires prior authorization. The system’s lack of urgency places a heavy burden on patients and physicians.

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