What question did this study set out to answer?

To determine whether insurance prior authorizations are associated with delayed biologic therapy initiation and increased adverse healthcare utilization in pediatric inflammatory bowel disease.

February 22, 2022PEDIATRICSOpen Access

Delays Related to Prior Authorization in Inflammatory Bowel Disease

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Authors

BCBrad D. ConstantChildren's Hospital Colorado EZEdwin F. de ZoetenChildren's Hospital Colorado MSMarisa G. StahlChildren's Hospital Colorado

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Implication

Retrospective cohort study shows prior authorizations prolong biologic initiation and raise acute care visits in pediatric inflammatory bowel disease, indicating a need for streamlined approvals.

Key Points

To determine whether insurance prior authorizations are associated with delayed biologic therapy initiation and increased adverse healthcare utilization in pediatric inflammatory bowel disease.
Retrospective cohort study of N=190 pediatric patients with inflammatory bowel disease initiating biologic therapy at a tertiary care hospital.
Multivariable linear regression evaluated the interval between physician recommendation and first dose, adjusting for demographics, insurance type, and disease severity.
Propensity score methods estimated associations between prior authorization status and both 180-day healthcare utilization (emergency visits, hospitalizations, surgeries) and 90-day corticosteroid dependence.
Standard prior authorizations and complicated authorizations were associated with a 10.2-day (95% CI 8.2 to 12.3) and 24.6-day (95% CI 16.4 to 32.8) increase in biologic initiation time, respectively, relative to a 21-day median baseline.
Prior authorizations increased the likelihood of IBD-related healthcare utilization within 180 days by 12.9% (95% CI 2.5 to 23.4).
Prior authorizations increased the risk of corticosteroid dependence at 90 days by 14.1% (95% CI 3.3 to 24.8).

Cite This Study

Constant et al. (2022) studied this question.

synapsesocial.com/papers/6a907f3af5c79ce9992db9d8 https://doi.org/10.1542/peds.2021-052501

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Implication

Retrospective cohort study shows prior authorizations prolong biologic initiation and raise acute care visits in pediatric inflammatory bowel disease, indicating a need for streamlined approvals.

Delays Related to Prior Authorization in Inflammatory Bowel Disease

Discussion

Member takes

Implication

Key Points

Cite This Study

Delays Related to Prior Authorization in Inflammatory Bowel Disease

Discussion

Member takes

Implication

Key Points

Cite This Study

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