I work in a headache clinic. Most of our treatments, at this time, are "off-label." When I prescribe a medication that is denied, the pharmacist tells the patient that I just have to do a prior auth and they can get it. I (and my MA who spends 50% of her time doing this) completes the prior auth, however, the prior auth requires a stratified treatment based on the medication's FDA-approved indication. I explain and even include studies to show the potential benefit for headaches. The prior auth is denied and the information given to the patient, either by the pharmacist or by the patient's insurance rep, is that a) I didn't do the prior auth correctly, or b) it was not the right medication for that patient. Both statements seriously erode the patient's trust in my knowledge and ability to help them.