ArticlePediatrics2022
Delays Related to Prior Authorization in Inflammatory Bowel Disease.
Article in Pediatrics, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
24 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The association between cost sharing, prior authorization, and specialty drug utilization: A systematic review.Journal of managed care & specialty pharmacy · 2023Pooled it
- Evaluating the access process for patients transitioning from intravenous to subcutaneous biologic administration for inflammatory bowel disease.Crohn's & colitis 360 · 2026Article
- A Comparison of Biological Therapies vs Traditional Immunosuppressant in the Management of Inflammatory Bowel Diseases: A Narrative Review.Journal of community hospital internal medicine perspectives · 2026Review
- A significant number of pediatric inflammatory bowel disease patients are exposed to a medication not approved by the Food and Drug Administration for pediatric use.Journal of pediatric gastroenterology and nutrition · 2025Article
- Real-world phosphorodiamidate morpholino oligomer treatment patterns in Duchenne muscular dystrophy: a claims-based analysis.Journal of comparative effectiveness research · 2025Article
- Prolonged time to treatment of biologics in inflammatory bowel disease: disparities from a retrospective study in a tertiary referral centre in the UK.BMC gastroenterology · 2025Article
- National perspectives of barriers by insurance and pharmacy benefit managers in pediatric inflammatory bowel disease.JPGN reports · 2025Article
- Higher Rates of Delay in Starting Advanced Inflammatory Bowel Disease Therapies Linked to Insurance Delays, Intravenous Infusions, and Lack of Pharmacy Support.Clinical and translational gastroenterology · 2025Article
- Modern Advanced Therapies for Inflammatory Bowel Diseases: Practical Considerations and Positioning.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2025Review
- Insurance Denial of Biologic Therapy is Associated With Reduced Remission Rates in Inflammatory Bowel Disease Patients.Gastro hep advances · 2025Article
- Efficacy and Safety of Anti-Tumor Necrosis Factor Alpha in Very Early Onset Inflammatory Bowel Disease.Inflammatory bowel diseases · 2024Article
- Perceptions of prior authorization burden and solutions.Health affairs scholar · 2024Article
- Factors Associated with Delays in Initiating Biologic Therapy in Patients with Inflammatory Bowel Disease.Digestive diseases and sciences · 2024Article
- Comparison of prior authorization across insurers: cross sectional evidence from Medicare Advantage.BMJ (Clinical research ed.) · 2024Article
- Advanced Therapies for Inflammatory Bowel Disease: Navigating Payor and Financial Challenges.Current gastroenterology reports · 2024Review
- Discordance Between Inflammatory Bowel Disease Specialists and Insurance Authorization Denials-A Survey of Specific Inflammatory Bowel Disease Treatment Scenarios.Crohn's & colitis 360 · 2024Article
- Burden with No Benefit: Prior Authorization in Congenital Cardiology.Pediatric cardiology · 2024Article
- The PA System: Is Prior Authorization for Dose Escalation of IBD Biologic Therapy a Tolerable Alternative or a Perpetual Annoyance?Digestive diseases and sciences · 2023Article
- Insurance Approval Delay of Biologic Therapy Dose Escalation Associated with Disease Activity in Patients with Inflammatory Bowel Disease.Digestive diseases and sciences · 2023Article
- Real-World Persistency for Inflammatory Bowel Disease Biologics Using Patient Registry Data.Crohn's & colitis 360 · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
Abstract
backgroundDelays in advancing to biologic therapies are associated with adverse outcomes in inflammatory bowel disease (IBD). Insurer-mandated prior authorizations have been linked to prolonged medication initiation times. We hypothesized that prior authorizations are associated with prolonged biologic initiation time and increased IBD-related healthcare utilization among children with IBD.
methodsWe performed a retrospective cohort study of 190 pediatric patients with IBD initiating biologics at a tertiary care hospital to measure the association between prior authorization, biologic initiation time (physician recommendation to first dose), and healthcare utilization (hospitalization, surgery, or emergency department visit). Demographic, insurance, and disease severity-related covariables were collected. Multivariable linear regression was used to measure the association between prior authorization and biologic initiation time. Propensity score methods were used to measure the associations between prior authorization and IBD-related healthcare utilization within 180 days and corticosteroid dependence at 90 days, with adjustment for insurance type, demographics, and disease severity-related characteristics.
resultsMedian biologic initiation time was 21 days. Prior authorization and complicated prior authorizations (requiring appeal, step therapy, or peer-to-peer review) were associated with 10.2-day (95% confidence interval [CI] 8.2 to 12.3) and 24.6-day (95% CI 16.4 to 32.8) increases in biologic initiation time, respectively. Prior authorizations increased the likelihood of IBD-related healthcare utilization within 180 days by 12.9% (95% CI 2.5 to 23.4) and corticosteroid dependence at 90 days by 14.1% (95% CI 3.3 to 24.8).
conclusionsPrior authorizations are associated with prolonged biologic initiation time and increased IBD-related healthcare utilization. Minimizing prior authorization-related delays may expedite biologic delivery and reduce the risk of IBD-related healthcare utilization.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.