Patients Oppose Prior Authorization Policies, Finds New Poll

A majority of healthcare consumers oppose prior authorization policies imposed by health insurance companies and pharmacy benefit managers (PBMs), which often result in access restrictions, increased patient costs, and delayed health and wellness, finds a new poll commissioned by Let Me Doctors Decide. The organization is a national partnership convened by the Autoimmune Association in 2017 to raise awareness about affordability and access issues.

The nationwide poll, conducted by Lake Research Partners and the Tarrance Group, found that:

• 75% of healthcare consumers are concerned that prior authorization can delay or block patients’ access to treatment.
• 71% are worried that prior authorization will increase patient costs.
• 74% expressed concern that prior authorization can require patients to substitute less effective or ineffective treatments for what their doctors prescribed.
• 72% said they are concerned that such policies can override doctors’ recommendations by allowing insurance companies to control treatment decisions.

“Prior authorization, step therapy and other harmful barriers further complicate health issues and defer wellness for more than 50 million patients who are dealing with existing complications because of their immune-mediated diseases,” Quardricos Driskell, executive director of LMDD and vice president of public policy and government ffairs at the Autoimmune Association, said in a press release. “It’s time to level the playing field for patients with meaningful reforms that will break down insurance company and PBM barriers to ensure increased access to much-needed medicines and treatments.”

Related: Analysis: Payers Restrict Medications for Autoimmune Diseases

Health insurance plans and PBMs receive poor grades for ensuring access to medications for patients living with autoimmune diseases, according to recent scorecard conducted by Let My Doctors Decide, that assesses the restrictions payers place on therapies that help patients managed their conditions. They found that three out of four plans scored a “C” or an “F” because of those restrictions.