Several years ago, while bored on a Saturday afternoon, I was “channel surfing” on my television and saw an infomercial for a rotisserie oven. The spokesperson, Ron Popeil, repeatedly used the tag line, “just set it and forget it” to show how easy it was. While “set it and forget it” may work when making rotisserie chicken, it does not usually get the job done when it comes to prescription prior authorizations (PA).
Providers may go through the process of completing and submitting a PA when writing the initial new prescription (NRx) for a patient. However, most PAs are approved by the plan for twelve months or less. If the prescriber has written a medication for chronic conditions, this means that the patient will not get coverage after the PA expires unless a second PA is submitted. For many of these patients, it is appropriate to continue therapy for several years. At PARx, we have found that providers resubmit PAs for their patients upon expiration only 5 or 6 percent of the time. This presents a tremendous opportunity for patients, providers, and pharma brands.
Earlier this year, PARx launched our reauthorization program. For interested sponsors, PARx provides notifications to providers a few weeks prior to a PA expiration. The notification informs the provider that a PA has been initiated in the PARx PASS system and directs the provider to complete and submit the partially completed PA. By making the reauthorization process simple for providers, this new program has produced spectacular results to date:
Upon receiving notification from PARx of the expiring PA, 50-60% of providers resubmit a PA request.
The PA approval rate for these second submissions is averaging 96 percent. Compared to the 5-6% submission rate without notification, this program creates thousands of additional prescriptions for our sponsor brands.
More importantly, patients are able to continue on their chronic therapy without interruption.
When it comes to PA, providers who work with PARx can “set it and forget it,” thanks to a timely renewal reminder – and rest easy knowing their patients will continue to have access to the Rx they deem best for their treatment.
As part of our dedication to providing physician practices with the insights they need to lessen the impact of PAs on office workflow and most importantly, to better ensure that patients received the medications their doctors deem best for their treatment, my colleagues and I have unveiled a free podcast series entitled “Meeting the Prior Authorization Challenge: A Prescription for Patients and Physicians“. The series consists of short, insightful conversations with members of the PARx Solutions team, doctors, and practice staff.
Prior authorizations aren’t going away, so it is essential that physician offices empower themselves to better handle the process. Who better to hear from on PAs than doctors and practice managers managing this process on a daily basis? By giving a voice to their frustrations, we hope to raise awareness of the solutions PARx offers at no cost to physician offices.
Topics thus far addressed in the podcast series include:
Episode One: What is PARx Solutions, and why do I need it?
Yours truly launches the podcast series by explaining what prior authorization are and the challenges they raise for physician practices. I also provide an overview of the service provided by PARx Solutions is and how it helps improve practice workflow and patient access to prescribed medications.
Episode Two: Prior authorizations and ophthalmology
Ophthalmologist Dr. Bingjing Roberts weighs in on the importance of prior authorization within her line of medicine and highlights how working with a PA provider has been helpful in ensuring her patients receive the prescriptions they need.