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Americans favor prior authorization reform


Close to half oppose insurance companies requiring them at all, poll finds

Nearly half of respondents to a recent poll oppose the use of prior authorizations for prescription medications and about two-thirds think reforming the process should be a high priority for federal and state policymakers.

After receiving a brief explanation of prior authorizations, 49% of respondents had a “somewhat” or “very” unfavorable view of them, while 39% viewed them “somewhat” or “very” favorably. The rest had no opinion.

The survey of 1,000 adults was commissioned by the Autoimmune Association and took place online in early November of 2022. It includes language explaining that prior authorizations are “a health insurance company process that requires patients and doctors to wait for written approval from the insurance company before being able to access doctor-prescribed treatments or care.”

Respondents’ biggest worry about prior authorizations is their potential for delaying or blocking patients’ access to treatment, with 75% saying they are somewhat or very concerned about those possibilities. Among other concerns are:

  • Prior authorizations requiring patients to substitute ineffective or less effective treatments for what their doctor prescribed (74%)
  • Prior authorizations delaying relief by requiring patients to try less effective treatments, (73%), and
  • Prior authorizations having the effect of allowing insurance companies to control treatment decisions (72%)

Asked whether prior authorization reform should be a priority for lawmakers, 64% say it should be, including 27% who think it should be a top priority. The demographic groups most likely to say it should be a priority include African Americans (72%), Democrats and women over 45 (both 69%), and residents of western states (68%).

Groups most likely to say reform should not be a legislative priority are men over 45 (31%); Midwestern residents (30%); and white people, Republicans, and independents (each 29%).

Among proposals for reforming prior authorizations, requiring insurance companies to respond to a prior authorization request within a specified period and making information about prior authorization requirements available to doctors and patients were the most popular, with 80% of respondents viewing each favorably or somewhat favorably. Those were followed by requiring insurance companies to cover all FDA-approved medications when prescribed by doctors (79%) and requiring insurers to adopt electronic prior authorization processes (77%).

“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, vice president of public policy and government affairs at the Autoimmune Association said in an accompanying news release. “It’s time to level the playing field for patients with meaningful reforms that will break down insurance company…barriers to ensure increased access to much-needed medicines and treatments.”

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