Patients and Physicians Speak Out

I waited weeks to get preauthorization for my cancer pills (Abiraterone Acetate), which is a part of my doctor's treatment for prostate cancer that has spread. Not only has it delayed my treatment, but it caused me great stress and mental anguish, while all I should be worried about is fighting this awful illness. Something needs to be done about this!!!

I am a caregiver for my husband, and we are both 78 and 79. We are having a problem getting my husband's cancer medication, because of prior authorization. This has to stop!!! The doctor is prescribing this medication as part of his treatment, because he needs it to live!!! It doesn't matter how old you are, LIFE IS PRECIOUS!!! This prior authorization and decision is being made by people who are not doctors, and they are overriding what the doctor knows is the medication and treatment that you need to survive. [Prior authorization’s] causing great harm and unneeded stress to patients and loved ones when they're already fighting for their life against cancer that, without their prescribed medication, could and will kill them. Something needs to be done about this. IT IS SO WRONG!!!

On top of having to live with chronic pain, my patient had to endure acute pain without additional pharmacological support because Medicare wouldn't approve the appropriate (and safe) pain prescription. The patient cared for himself and used his street connections to (unsafely) treat his pain.

As a country, we take pride in medical innovation. We say that the value of our system is the new procedures or medications we create. But I don’t think I’ve ever successfully prescribed these medications to the patients who need them. I’m early in my career and every time I’ve tried, I’ve encountered paperwork like prior authorizations. As a new physician, this can be a nearly unsurmountable barrier. No one teaches you how to complete these forms. This is a major barrier to care for my patients, and a major disservice to medicine as a whole because it prevents us from progressing. When we can’t use the medications that we have available, we’re letting our patients down and wasting the resources we have available.

I’ve wanted to be a primary care doctor for as long as I can remember. The reason being, I didn’t feel like my family had a quarterback who was directing our care, preventing illnesses we didn’t see coming and mitigating the burdens of diseases that already were at work. The single most frustrating issue I have faced as a primary care physician, that constantly makes me second guess my dreams, is the [prior authorization] PA issue. I have young children with type 2 diabetes who have made so many healthy changes but have to keep taking insulin daily because they can’t get a once-weekly medication. I have reproductive aged women who worry about their fertility and future health because they are not able to lose weight and I can’t offer them an evidence-based, FDA-approved medication to assist them because Medicaid has just made access to GLP-1’s [glucagon-like peptide-1] for a weight loss indication non-negotiable. I feel helpless. I feel like I can’t do what I was trained to do because of the insurmountable, unnecessary barriers PA’s pose. Please help me help my patients. These medications will save money in the future by reducing the costs of heart failure admissions, necrotic diabetic foot admissions & ICU admissions for hypertensive emergency. Trust me.

I am a resident physician in Baltimore who takes care of adults and children. I wrote a prescription for a patient upon discharge to continue two important medicines that were started by an inpatient specialist while he was admitted to the hospital for over two months. I received two prior authorizations for these medicines requesting additional documentation for these medicines that he had been on for at least a month. This delayed him getting these medicines refilled, causing his parents to stretch the quantity of medicine they had and give him less than he needed. He was finally able to get the medicines after multiple physicians and other staff worked on it for over multiple hours. The system needs to be changed to allow patients to get timely and necessary care.