Frustrated with prior authorization? AAD’s new toolkit helps members find solutions

ColbyEvans.jpgBy Colby Evans, MD
Chair, Drug Pricing and Transparency Task Force

The growing burden of prior authorizations is something all of us deal with every day. The situation for dermatology is unique though in that we experience prior authorizations for both generic and specialty drugs. Everything from biologics for psoriasis to generic drugs to treat acne. This imposes a burden on our practices. A study by Morley et. al found “$2,161 to $3,430 is spent annually for each full-time equivalent physician completing PA requirements.1” Even with this cost barrier what concerns us most is we are forced to delay necessary treatment for our patients.   

An AAD survey found that dermatologists process six or more prior authorizations daily. The chart above shows the most common prior authorization drugs as cited by dermatologists. Learn more in the Prior Authorization and Drug Pricing Toolkit.

Hearing your concerns, the drug pricing and transparency task force took action. Over the course of the past few months the Drug Pricing and Transparency Task Force surveyed a small sample of membership to better understand and quantify the burden we experience. Specifically, the AAD sent surveys to a total of 208 AAD members and 500 Association of Dermatology Administrators & Managers (ADAM) members. Survey recipients were requested to forward the survey to those responsible for completing prior authorizations in their practices.

What we found is that most respondents claim to process six or more prior authorizations daily. Not being listed on a formulary, or being listed on a higher tier are key reasons for prior authorizations with some also citing step therapy and cost as reasons. Most importantly though, the majority agree that they have seen an increase in the number of drugs requiring prior authorizations and the subsequent delays in patient treatment this year. The Task Force will publish the full results in the coming months.

Keeping these results in mind and hearing individual concerns, the Drug Pricing and Transparency Task Force worked to develop a new toolkit to help you and your staff with prior authorization requests. The Prior Authorization/Drug Pricing Toolkit has been created to help dermatologists and their practice staff successfully navigate this challenging environment with the goal of increasing access to necessary medications for patients. The toolkit includes the following materials:

Please send us your feedback on the materials. We want to ensure these new tools help alleviate the burden of prior authorizations and all you to get necessary medications to your patients.

We need patient stories

Do you have a patient who has experienced step therapy and has it delayed them from accessing a necessary treatment? If so, then the AAD wants to hear from them. We'll use their story to help push for legislative reform. Please encourage patients to fill out an online form. Send them the following link:

1Morley CP, Badolato DJ, Hickner J, Epling JW. The impact of prior authorization requirements on primary care physicians’ offices: report of two parallel network studies. J Am Board Fam Med. 2013;26:93-95.