Pharma brands invest heavily in sales and marketing tactics aimed at convincing physicians to prescribe their product. Even when successful, these efforts represent only a first step in realizing more prescriptions that actually get dispensed. Particularly when a prescription requires prior authorization (PA), retail pharmacy data shows that the originally prescribed product ends up being dispensed less than thirty percent of the time. In two-thirds of cases, the medication is either switched to another product or abandoned altogether, leaving both patients and physicians frustrated. PA requirements are being implemented by payers for more brands across most therapeutic categories, so the negative impact on pharma continues to deepen. Read the full article
For many pharmaceutical brands, managed care restrictions put tremendous pressure on the ability for patients to access prescribed medications, even when their physicians deem a particular medication to be best suited to treat their condition. To combat this challenge, many brands have engaged third parties to implement programs designed to assist physician practices with managing the cumbersome prior authorization (PA) process. While these programs may help generate higher PA approval rates, this metric alone is insufficient in evaluating whether the program is truly beneficial to patients and impactful for the sponsoring brand. 
Talk with busy physicians and you’ll soon hear about the ever-increasing difficulty in getting approval for the medications that they believe are most appropriate for their patients. For pharma marketers, a superior efficacy, side effect and dosing profile is a necessary start, and a favorable managed care formulary position can be another positive step toward commercial success—but, more and more frequently, a prior authorization (PA) request must be approved before a medication can be dispensed and taken by the patient. 