It is not uncommon for patients to change pharmacy benefit managers when changing health plans or for health plans to change their pharmacy benefit manager.  Physicians and patients get caught in the crossfire of endless forms and calls while waiting for meds, which they have successfully taken for years, are now questioned.  It is very difficult to reconstruct a person's previous med history when we have changed to a new EMR and then find it hard to justify to the PBM why the person ended up on the regimen that is working for them.  It is a waste of time and potentially dangerous.  These requests involve FDA-approved drugs and often generic medications.

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Have you ever gone to the pharmacy to fill a prescription only to be told that your insurance company requires approval before they'll cover your treatment? Have you ever waited for days, weeks, or months for a test or medical procedure to be scheduled because authorization from an insurer? Or are you a physician frustrated with the administrative headaches and their impact on your patient?

Prior authorization is a burden on patients and physicians alike. The process is confusing, time consuming, and — most importantly — can cause delays in patients receiving the care they need.

Please tell us know how prior authorization has impacted you. We are looking for stories from patients and physicians to highlight and draw attention to this issue that is impacting the health of so many Americans.