Providers, Payors and Prior Authorization: A Second Front In Pricing Fight
A below-the-radar effort to streamline prior authorization policies could have important implications for easing access to high-priced medicines. A new consensus statement aligns large provider groups with payors on some first principles.
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FOURIER outcomes data presented at the American College of Cardiology annual meeting fell short of expectations, but could increase physician demand for the PCSK9 inhibitor, making it harder for payers to say no.
American Medical Association says its national physician survey shows preauthorization policies "negatively impact patient care."
The Alzheimer’s Association waged and won a six-month battle to end prior authorization programs for AD medications in three Medicare plans. The skirmish has big implications for future of Medicare formularies— and the balance of power between Big Pharma and managed care.