Oncologists: Prior Authorizations Lead to Delays in Getting Cancer Meds

The majority of oncologists report that they’ve encountered delays in treatment initiation due to prior authorization requirements, according to a survey by Sermo, a social network platform for healthcare providers.

In the survey of more than 300 oncologists, 80% report delays because of insurance hurdles and the complexities of prior authorization. These challenges are followed by the burden of high out-of-pocket costs and the limited availability of clinical trials.

“Prior authorizations are a major burden in our field and across cancer care in general,” Guy Jones, M.D., radiation oncologist and medical director of Oncology Nevada and a member of the Sermo medical advisory board, said in a news release. “It’s frustrating to see patients in pain or in need of urgent treatment delayed by barriers that ultimately serve no clear purpose. This process needs to be streamlined for timely care delivery.”

Prior approval for a drug is usually done to make sure medications are safe and used appropriately, according to insurance companies. But doctor surveys over the last few years have shown they are concerned that prior authorization creates a time-consuming burden for both providers and patients and could impact quality of care.

Most recently, in February 2025, the American Medical Association released results of a survey where physicians said prior authorizations delay patient care, lead to treatment abandonment, and negatively impact clinical outcomes. Among those surveyed, 94% said that prior authorization has a somewhat or significantly negative impact on patient clinical outcomes, with more than 1 in 4 (29%) reporting that it caused a serious adverse event for a patient in their care.

This survey also found that 61% of physicians expressed concerns that augmented intelligence either increases or will increase denial rates. This web-based survey was administered in December 2024 among 1,000 practicing physicians drawn from a Medscape panel.

Among oncologists specifically, there is concern about whether these policies waste time for physicians and delay access to needed care. Studies over the last few years have suggested these days can have a negative impact on care. In one study published in December 2023 in the Journal of Clinical Oncology, that new prior authorization on 11 previously prescribed oral anticancer drugs increased the probability of discontinued and delayed care.

And even patients are concerned. In a survey of patients published in October 2023 in JAMA Network Open, patients with cancer had increased anxiety and experienced decreased trust in the healthcare system.

The role of clinical trials

The Sermo survey also found that more than half (54%) of the oncologists always or often refer patients to clinical trials for new treatments. Oncologists are also relying heavily on data from these clinical trials in their decision-making process. The majority (77%) of oncologists believe that clinical trial data is the most influential factor in their decision to adopt a newly approved treatment.

According to a recent Nature analysis, 770 NIH research grants have been terminated as of April 7, 2025. More than 100 clinical trials funded by the NIH are now at risk of being halted due to the terminations, likely resulting in significant interruptions to patient care.