Evaluating the impact of prior authorizations in patients with complex dermatological conditions.

Abstract Background In dermatology, prior authorizations (PAs) can delay treatment, decrease patient adherence, and deter providers from advocating for their patients. Patients with complex dermatological conditions, often requiring off-label treatments, may face particularly significant insurance barriers. Objective Evaluate the impact of PAs in patients with complex dermatological conditions. Methods This prospective cohort study assessed patients seen by a dermatologist specializing in complex dermatology over 5 months. Patients included were >18 years old, seen at V.P.W.’s rheumatology-dermatology clinic, and prescribed a medication or ordered a diagnostic procedure that elicited an insurance PA. PA outcome, administrative time, and delay to treatment were collected. Results Of 51 PAs, 51% were initially denied, with systemic medications more likely denied than topical medications (p Limitations Single center, single provider patient panel. Conclusion Patients with complex dermatologic conditions face a significant barrier to care due to PAs. The administrative burden for provider practices to address these PAs is substantial and may warrant a streamlined system in collaboration with insurers.