Prior Authorizations: A Necessary Evil?

Along with general practice burdens, child and adolescent psychiatrists (CAPs) are commonly tasked with completing prior authorizations (PAs) for medications prescribed in clinical practice. CAPs frown in resignation to their PA requirements to allow patients to be initiated onto, or continue with, their medications. PAs are often required for both brand and generic prescription medications, sometimes to confirm if the medication is medically necessary and appropriate for the indication,¹ to review medication dosages, or more commonly to review the need in context to the medication cost of the requested agent relative to less expensive alternatives. Some states have implemented policies that leverage PAs to regulate and oversee provider prescribing patterns. Notably, many state Medicaid programs have restrictions on prescription of antipsychotics in children, and adoption of these regulations has led to decreases in their use in children 6 to 12 years old.².