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Team Archbow

• October 12

Prior Authorization Should be a Top Concern for Pharma — Here’s Why

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It can be hard to think of an aspect of healthcare more vexing than prior authorizations (PAs). In theory, PAs sound fine: Insurers require healthcare providers to give prior authorization for medical treatment to reduce unnecessary procedures and keep costs down.

However, prior authorizations have become a frustrating hurdle for prescribers and their patients, who often need immediate treatment. In fact, PAs are so frustrating that Congress is looking into a legislative solution and recently opened an inquiry into the matter.

But make no mistake: Prior authorization is also a challenge for pharmaceutical manufacturers and market access teams.

If your organization could benefit from an updated PA mindset, these two resources from our sister organization, Valuate Health Consultancy, may help:

- In the latest episode of The IDI podcast from Valuate, Senior Principal John Hennessy and Syam Palakurthy, CEO of SamaCare, explain why prior authorization is truly a manufacturer challenge. “If you want to have your product used by patients, you better care about prior authorization because it is probably the single biggest access barrier we know of,” Hennessy says.

Adds Palakurthy, “There’s a bit of fatalism with pharmaceutical manufacturers. Sometimes, we hear from manufacturers, and they’ll say, ‘The provider is the one who has to solve that, or there’s nothing we can do to help it. But there is a lot that the manufacturer can do as long as they’re working inside the prior authorization workflow.”

Listen on: Apple Podcasts or Spotify

- Hennessy also wrote this informative POV on prior authorization for pharma manufacturers, where he explains why pharma should care so much about PAs, how they can work to streamline PA transactions, and how four best practices can help more patients access the products they’re prescribed. He also debunks five PA myths and provides action items for market access teams to address their PA concerns.

If your team wants to tackle a PA problem, we can help. Contact us today to engage our team in the strategic design and execution of PA strategies that move the access needle.

Archbow Consulting, Entrée Health, and Valuate Health Consultancy are sister companies under the Value and Access division of Omnicom Health Group. Learn more about our united organizations here.

For additional insights on this topic, you may also enjoy the following:

Take the Pain out of Conversations About Coverage

Pharma Has a Pull-Through Problem; The Answer is Data

Market Access POV: ICER and Specialty Drug Coverage

Archbow Consulting helps pharmaceutical and biotech companies in the USA and Europe design, build, and optimize product distribution and patient access strategies. Archbow was founded by industry veterans to meet a need in the marketplace for consulting options that offer diverse real-world experience, are able to leverage deep connections across the industry, and can also provide actionable strategic guidance. We invite you to learn more about our team, services, and clients’ success, and connect with us via email, LinkedIn or subscribing to this blog which you can do below.

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