Drug access and affordability

Treatment decisions are best made by physicians in consultation with their patients. Policies such as prior authorization, which require insurance company approval of certain medications and services, place a third party with no knowledge of the complexity or full history of a patient’s condition in a decision-making position and impede patient access to the most effective treatment.

The Academy advocates with payers to reduce the impact of prior authorization. The Academy supports the “Improving Seniors Timely Access to Care Act,” legislation intended to relieve prior authorization burdens for services under Medicare Advantage (MA) plans, as well as provide transparency to patients and providers.

Dermatologists have the expertise to understand the interplay of factors — the efficacy and safety of all treatment options, comorbidities, the patient’s support system, and more — needed to make a treatment determination that works best for a specific patient.

In a survey of Academy members on prior authorization:

• More than 90% reported it had prevented or delayed treatment of the patient.

• More than two-thirds reported it negatively affecting at least one patient per day.

Physician practices are on the front line, and complying with management utilization has driven up the cost of running a medical practice. On average, dermatologists dedicate 8 hours per week solely to administrative activity. This precious time should be dedicated to patient care.