APhA Policy Manual

Prior Authorization

PATIENT/PHARMACIST RELATIONSHIPS

APhA opposes prior authorization programs that create barriers to patient care.
Patients, prescribers, and pharmacists should have ready access to the coverage conditions for medications or devices requiring prior authorization.
Prescription drug benefit plan sponsors and administrators should actively seek and integrate the input of network pharmacists in the design and operation of prior authorization programs.
APhA supports prior authorization programs that allow pharmacists to provide the necessary information to determine appropriate patient care.
APhA expects prescription drug benefit plan sponsors to compensate pharmacy providers who complete third-party payer authorization procedures. Compensation should be in addition to dispensing fee arrangements.
APhA should work with relevant groups to improve prior authorization design and decrease prescription processing inefficiencies.