Threshold denial rates in prior authorization prescription programs

In this special report, the economics of prior authorization is examined with a focus on the break-even rate that requests are denied. Using a simple theoretical model, comparative static results are derived and used to consider the cost-effectiveness implications of future changes in prior authoriz...

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Bibliographic Details
Published in:Expert review of pharmacoeconomics & outcomes research 2004-04, Vol.4 (2), p.165-169
Main Authors: Grant, William C, Yoder, David M, Mullins, C Daniel
Format: Article
Language:English
Subjects:
Cost benefit analysis
cost-effectiveness
denial rates
Drugs
Evaluation
Health maintenance organizations
Laws, regulations and rules
Management
Medical care, Cost of
Methods
Pharmacy
Prescribing
Prescription drug plans
prior authorization
Services
threshold
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Description
Summary:In this special report, the economics of prior authorization is examined with a focus on the break-even rate that requests are denied. Using a simple theoretical model, comparative static results are derived and used to consider the cost-effectiveness implications of future changes in prior authorization policies.
ISSN:1473-7167
1744-8379
DOI:10.1586/14737167.4.2.165