Benched by Bureaucracy: How Electronic PA Gets Prostate Cancer Patients Back in the Game

Every September, Prostate Cancer Awareness Month encourages more men to get screened—and that can translate to more positive outcomes.

An estimated 313,780 American men will face a prostate cancer diagnosis in 2025, but early detection leads to excellent outcomes with a 98% five-year survival rate. Awareness campaigns help, but to win against this disease, patients need access to the full array of available treatments.

Prior Authorization Inefficiencies Delay Access

Prostate cancer treatment includes a list of breakthrough specialty medications—from next-generation hormone therapies to advanced radiopharmaceuticals—and almost all of them require patients and providers to jump though administrative hoops.

A recent study of cancer patients published in the Journal of the American Medical Association (JAMA) shows us how widespread prior authorization delays have become:

• 69% of respondents experienced prior authorization-related delays in their care

• Of those with delayed care, 73% faced delays of two weeks or longer

Prior authorization (PA) delays are no mere inconvenience—they cause uncertainty and worry. Patients are left in the dark, weighing the financial risk of moving forward without approval against the fear of disease progression.

Electronic Prior Authorization: The Game-Changer Patients Deserve

When a patient faces a serious diagnosis like prostate cancer, speedy access to prescribed therapies is critical. That’s why the complex and time-consuming prior authorization process for specialty medications—particularly when drugs fall under medical benefits—requires sophisticated technology solutions.

Electronic prior authorization (ePA) addresses delays by integrating with your electronic health record (EHR) system to eliminate the frustrating data silos that slow everything down. Patient-specific benefits verification instantly identifies copays and deductibles at the point of care and calculates patient out-of-pocket costs. The solution determines if prior authorization is needed, checks for errors, submits requests, and tracks status—all in one place.

Having a single view of PA status reduces follow-up calls and the mind-numbing task of jumping in and out of various payer portals.

The Council for Affordable Quality Healthcare (CAQH) is projecting that ePA will result in significant benefits such as:

• Industry-wide savings of around $515 million

• Administrative efficiency and provider time savings of 14 minutes per transaction
  

Beyond Awareness: Building Better PA Systems

While Prostate Cancer Awareness Month highlights how early detection saves lives, it’s important to also address the systemic barriers that can delay access to life-saving treatments.

Electronic prior authorization is an essential tool for ensuring that patients can access the breakthrough therapies that awareness campaigns celebrate.

Get the Guide: Unlock Faster Access to Treatment

Ready to transform how your organization handles prior authorization for the specialty medications that treat prostate cancer and other diseases? Get our comprehensive guide to discover:

• Why specialty medication PAs are more complex when they fall under medical benefits vs. pharmacy benefits

• How upcoming regulatory deadlines are influencing technology compliance requirements

• What medication management technology can do to streamline your workflows

Download your free guide now.