Print
Insurance companies often restrict University of Utah Health physicians from prescribing the optimal drug for a patient s illness.
Providers are left to choose between the second or third choice after insurers initially deny coverage, in part, to steer doctors and patients toward lower-cost options. In some cases, patients have to go through months of ineffective treatment to merit a more expensive drug, said Erin Fox, senior pharmacy director at University of Utah Health, which has an entire pharmacy technician team devoted to prior authorizations. Our providers are overall especially frustrated with prior authorizations because they often aren t allowed to prescribe what would be the best treatment for an individual patient, she said, noting the step therapy or fail first requirement. The patient has to pay copayments for these visits and may suffer overall worsening of disease state while they make the case to the payer.