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Advocating for Patients With Inflammatory Bowel Disease: How to Navigate the Prior Authorization Process

机译：倡导炎症性肠病患者：如何浏览先前的授权过程

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摘要

In an effort to manage health care costs and avoid improper medication use, prior authorizations (PAs) have become a standard stipulation required by payers in the determination of medication coverage. For gastroenterologists managing patients, especially those with inflammatory bowel disease (IBD), the PA process is time-consuming and further complicated by 2 additional factors: step therapy requirements and failure of payers to recognize updated IBD treatment pathways. These factors often lead to PA denials and cause treatment delays, which in turn can lead to disease progression, ongoing patient suffering, and ultimately an increase in both direct and indirect total costs. In this manuscript, the PA process, PA models, tips and available resources to navigate the PA process, and future advocacy efforts are discussed with the intent to help gastroenterology practices optimize PA outcomes and improve the care provided to patients with IBD and other gastrointestinal disorders.
机译：在努力管理医疗费用并避免药物治疗使用不当，事先授权（PAS）已成为付款人在确定药物覆盖范围内所需的标准规定。 对于胃肠学主进行管理患者，特别是那些具有炎症性肠病（IBD）的患者，PA过程是耗时的，并且通过2个额外因素进一步复杂化：步骤治疗要求和付款人未能识别更新的IBD治疗途径。 这些因素经常导致PA拒绝并导致治疗延迟，这反过来可能导致疾病进展，持续的患者遭受痛苦，最终增加直接和间接的总成本。 在此手稿中，PA流程，PA模型，提示和可用资源导航PA流程，以及未来的宣传工作旨在帮助胃肠学实践优化PA结果，并改善为IBD和其他胃肠道患者提供的护理 。

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