More than 90% of physicians say they have experienced prior authorization (PA)-related delays to providing medically necessary care for their patients -- and the problem can be even worse for African American patients, according to a white paper from the Association of Black Cardiologists (ABC).
Barriers to care seem insurmountable for underserved minority populations; in fact, 75% of
cardiologists reported that a PA-related delay has led some patients to abandon their treatment, ABC says.
So earlier this month
ABC issued a tool to ease the PA process, designed specifically for providers caring for minority heart patients – the Prior Authorization Resource Kit.
The kit provides clinical support for three relatively new heart therapies:
- Lowering cholesterol using a class of drugs known as proprotein convertase subtilisin/kexin type 9, or PCSK9 inhibitor therapy,
- Reducing stroke risk using direct oral anticoagulants (DOACs) to treat or prevent blood clots and
- Treating heart failure with angiotensin receptor/neprilysin inhibitors (ARNi).
ABC selected those therapies after
a survey of cardiologists found that African American patients – who have the highest rate of heart disease and stroke of any U.S. ethnic group – also face significant difficulty accessing the most advanced medications and devices to treat those ailments.
PA requirements, in particular, can trigger denials as often as 62% of the time, practices reported, while 43% of physicians surveyed said they did not have sufficient employee resources to handle PA documentation, submissions and appeals.
All told, 73% of the surveyed physicians agreed with the statement that whites with heart disease are more likely than some minorities with heart disease to get the newest medicines and treatments.
“This is particularly important in helping the dedicated providers, who treat high risk patients in underserved communities,” observes Dr. Keith Ferdinand M.D., chair of the ABC Access to Care Initiative, which issues the kit. “The sacred provider-patient relationship is increasingly hampered by the ‘third person in the room.’ And the uniqueness of the ABC [Prior Authorization] Resource Kit will help providers and practices with limited resources to overcome specific barriers to care and to treatment.”
The ABC Access to Care Initiative is supported by seven device and pharmaceutical companies, including Amgen, Arbor Pharmaceuticals, AstraZeneca, Boston Scientific, Bristol-Myers Squibb/Pfizer, Novartis and Sanofi/Regeneron.