In this blog, we focus on the important role of Drug Review Committees in maintaining a responsive and sustainable PA process through a regular review of existing medications as well as reviewing new medications that may be subject to prior authorization.
The interest in prior authorization is growing, which is driving more interest in reforming current practices and policies to become more efficient and drive down administration costs and reduce the time-consuming claims process.
Navigate the prior authorization (PA) process in Canada can be time consuming and confusing. Inefficiencies in the system create real challenges for all stakeholders—physicians, pharmacists, insurers, advisors, and most importantly, patients.
Patient Support Programs (PSPs) may secure alternate funding from pharmaceutical manufacturers when there are reimbursement gaps, but that is just one role.
Did you know that changing group insurance carriers can result in loss of access to specialty medications for plan members? This can happen even when a plan member’s claim has been approved through prior authorization with the old carrier, usually for twelve months, and there are no changes to the drug plan formulary with the new carrier.
The Prior Authorization Framework and Accreditation (PAFA) Program is an exciting new development in the Canadian specialty drug landscape that will benefit patients, plan sponsors, and other industry stakeholders, including payers.
The Simplify Prior Authorization initiative is an advocate for education about prior authorization (PA) and improvement in current prior authorization practices and processes. If your organization is interested in finding out more, getting involved, or in sponsorship of this important initiative, please contact us via the link below.