ArticleJournal of clinical oncology : official journal of the American Society of Clinical Oncology2024
Prior Authorization and Association With Delayed or Discontinued Prescription Fills.
Article in Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers.
What it found
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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.
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Who cites it
25 citing papers in PubMed.
- Quality, Cost, and Timeliness of Cancer Treatment in Medicare Advantage and Traditional Medicare.JAMA internal medicine · 2026Article
- Second-Level Appeals of Denied Anticancer Medication Claims in Medicare Part D.JAMA network open · 2026Article
- Patient and Caregiver Involvement With Prior Authorization and Care Delivery and Delays.JAMA network open · 2026Article
- Pre-Claim Review And Traditional Medicare Home Health Spending: Evidence From 4 States.Health affairs (Project Hope) · 2026Article
- Prior Authorization and Associated Delays and Denials of Branded Medication Dispensation.JAMA health forum · 2026Article
- State Medigap Policies and Disenrollment From Medicare Advantage Among Beneficiaries With Cancer.JCO oncology practice · 2026Article
- State Prior Authorization Prohibitions and Buprenorphine Retention Among Privately Insured Patients.JAMA health forum · 2026Article
- Trends in prescription drug coverage restrictions in Medicare, Medicaid, and commercial insurance plans, 2011-2019.Health affairs scholar · 2026Article
- Characterizing and Addressing the Financial, Time, and Administrative Burdens of Cancer and its Care.Current treatment options in oncology · 2025Review
- Patient administrative burden: a scoping review.Health affairs scholar · 2025Review
- Prior Authorization, Quantity Limits, and Step Therapy for Patient-Administered Antiemetics.JAMA network open · 2025Article
- Treatment Landscape for Older Men With Metastatic Hormone-Sensitive Prostate Cancer in the United States.Cancer medicine · 2025Article
- Treatment Burden Among Older Adults in the United States, 2022.Journal of the American Geriatrics Society · 2025Article
- Use of Low-Value Cancer Treatments in Medicare Advantage Versus Traditional Medicare.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2025Article
- The effect of providing Medicare Advantage enrollees diagnosed with cancer additional time to reassess enrollment.Health affairs scholar · 2025Article
- The administrative burden of medication affordability resources: an environmental scan with implications for health informatics to advance health equity.Journal of the American Medical Informatics Association : JAMIA · 2025Article
- Medigap Protection and Plan Switching Among Medicare Advantage Enrollees With Cancer.JAMA health forum · 2025Article
- Evidence-based SGLT2 inhibitor and GLP-1 receptor agonist use by race in the VA healthcare system.American journal of preventive cardiology · 2025Article
- Disparities in treatment delays among metastatic breast cancer patients: insights from nationwide electronic health records, 2011-2022.Breast cancer research and treatment · 2025Article
- Procedural Prescription Denials and Risk of Acute Care Utilization and Spending Among Medicaid Patients.JAMA network open · 2025Article
Corrections and comments
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Authors and funding
2 authors.
Funding
Abstract
purposePrior authorization requirements are increasing but little is known about their effects on access to care. We examined the association of a new prior authorization policy with delayed or discontinued prescription fills for oral anticancer drugs among Medicare Part D beneficiaries.
methodsUsing Medicare part D claims data from 2010 to 2020, we studied beneficiaries regularly filling one of 11 oral anticancer drugs, defined as three 30-day fills in 120 days preceding the plan's prior authorization policy change on that drug and continuously enrolled in the same plan for 120 days before and after the policy change at the start of a new year. The control group consisted of beneficiaries meeting the same utilization criteria, but who were enrolled in plans at the same time that did not implement a prior authorization policy change. The outcomes of interest were discontinuation of the drug within 120 days (analyzed with regression analyses) and time (in days) to next fill after a prior authorization policy change (analyzed using a quasi-experimental difference-in-differences event study).
resultsThe introduction of a new prior authorization on an established drug increased the odds of discontinuation within 120 days (adjusted odds ratio, 7.1 [95% CI, 6.0 to 8.5];
conclusionIntroduction of a new prior authorization policy on an established drug regimen is associated with increased probability of discontinued and delayed care. For some conditions, this may represent a clinically consequential barrier to access. Waiving prior authorization for patients already established on a drug may improve adherence.
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