Managed Care organizations MCOs and pharmacy benefit management companies PBMs offer their clients prior-authorization programs for selected drugs. The large amounts of money that prior authorization programs save accrue to the MCO, PBM, or sponsoring employer. The dispensing pharmacy does not share in the proceeds, even though it shoulders a significant part of the administrative burden of operating the program. The Center for Pharmaceutical Health Services Research CPHSR proposes a study to evaluate the burden that the avarage prior authorization prescription places on the pharmacy, expressed in terms of the time and activities required relative to a new prescription that does not require prior authorization. The proposed research will consist first of a small-scale pilot and, second, a more complete study. Armed with factual information, dispensers are more likely to be successful in negotating realistic dispensing fees to cover the additional costs of prior authorization prescriptions.
Temple University School of Pharmacy