Impact of Prior Authorization of Antiepileptic Drugs in Children With Epilepsy

Pediatric Neurology
Elaine C WirrellKatherine C Nickels

Abstract

We assessed how commonly prior authorization results in treatment delay or missed doses in children with epilepsy. Parents of 462 children followed in a pediatric epilepsy clinic were surveyed regarding prior authorization in the preceding year. Epilepsy and insurance details were collected. If prior authorization was required, parents were asked whether it resulted in (1) delayed initiation of a newly-prescribed antiepileptic drug, and/or (2) lapse in coverage of a current medication. Prior authorization was defined as smooth if there was a less than seven day delay in starting a new antiepileptic drug and no lapse in coverage of a current medication. A total of 164 families (35%) returned completed surveys. Mean age of the children was 11.2 (S.D. 5.3) years and 67.4% experienced seizures more than every three months despite trials of two or more antiepileptic drugs. Primary insurance was private in 82.9% and Medicaid in 15.2%. Prior authorization was required in 63 (38.4%) cases, and proceeded smoothly in only 31 (49.2%). Twenty-three children experienced a delay of seven days or more in starting a new drug, and 24 experienced a lapse in coverage of their current medication, 11 of whom missed doses. Of these 11, seven had inc...Continue Reading

Citations

Sep 24, 2019·The Annals of Otology, Rhinology, and Laryngology·Jena PatelMaurits Boon
Jan 21, 2020·Expert Opinion on Pharmacotherapy·Jinhao HuangRongcai Jiang
Jun 1, 2020·Neurology and Therapy·Darshan MehtaAndrew Lee
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Nov 11, 2020·Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery·Vanessa F TorrecillasJeremy D Meier
Apr 13, 2021·Health Economics, Policy, and Law·Louis Tharp, Zoe Rothblatt

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