The Burden of Prior Authorizations for Pediatric Pulmonary Hypertension Medications: A Quantitative Assessment
This study quantified prior authorization (PA)-insurance-required approval-burden for pediatric pulmonary hypertension (PH) at an accredited center. Among 53 patients, 72% of 283 prescriptions between 2021 and 2023 required PA, with non-FDA-approved medications showing highest volume. Despite 97% approval and all patients ultimately obtaining medication, delays (mean 4.2 days), repeat requests (39%), and reliance on patient assistance programs created significant administrative burden. Results highlight the need for policy reform to ensure timely, equitable access to essential therapies.
Authors
- Kelly Merrill (ORCID: https://orcid.org/0009-0002-6020-7954)
- Delphine Yung (ORCID: https://orcid.org/0000-0002-4571-4977)
- Anne L. Davis
Institutions
- Seattle Children's Hospital (US)
- University of Washington (US)
Publication Details
- Journal
- Pulmonary Circulation
- Published
- 2025-10-01
- DOI
- https://doi.org/10.1002/pul2.70221
- Primary Topic
- Heart Failure Treatment and Management
- Type
- article
- Field-Weighted Citation Impact
- 0.00