The current prior authorization process required for anti-VEGF medications leads to treatment delays, increased health care costs due to administrative burdens and potentially worse visual outcomes.
A prospective study assessed nine retina practices in six U.S. states. A total of 2,365 anti-VEGF intravitreal injection prior authorization (PA) requests were logged, of which 2,225 met the inclusion criteria and 2,140 (96.2%) were approved. Sixty-four percent were reauthorizations for a previously used medication.
Although the approval rate was high, only 40% of the PA requests were approved on