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Insurance has always had a direct effect on the world of prescription medications. After all, it’s the insurance companies’ decision that makes the determination on what they will, and will not, cover. As the drug industry continues to grow, so does the insurance companies need for prior authorization.
Prior authorization is the insurance companies process where doctors must contact the insurance companies to get authorization for a particular drug therapy. In most cases a doctor must call up and give the appropriate criteria to make the drug therapy acceptable. If a patient had constipation, but not chronic constipation, insurance might not pick up the daily laxative medication.
In the past, such things have been more about the paper work to process these claims, than any real determination. It was understood that in most cases a drug company would authorize certain drugs because of their effectiveness. However, these days insurance companies are saying no to a lot of the drug therapies out there and not letting patients buy Cialis online along with other remedies.
The main reason has been cost. The insurance prices of drug therapies, especially those newer to the market, are on the rise. Insurance companies have been hesitant to allow newer drugs to be approved because they feel the doctors have gone through the proper step therapy.
Other reasons that these insurance companies are not authorizing new drugs is the growing availability of over the counter medications. While there are still prescription drugs like Protonix and Nexium, but there is also a growing number of drug therapies that are available over the counter and hence do not need prior authorization.
Insurance companies are getting strict on prior authorizations. Doctors are, in turn, learning that they will need to take more steps to get patients their medication.





