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Prior Authorization Leads to Radiation Oncology Treatment Delays, Patient Harm

By Lori Solomon HealthDay Reporter

Medically reviewed by Carmen Pope, BPharm. Last updated on Dec 9, 2024.

via HealthDay

MONDAY, Dec. 9, 2024 -- Prior authorization delays lead to serious harm for people with cancer, according to a survey conducted by the American Society for Radiation Oncology (ASTRO).

The survey, conducted in the fall of 2024, included responses from 754 physicians from across the United States, representing both academic (47 percent) and private (51 percent) practices in different types of communities (49 percent urban; 39 percent suburban; 13 percent rural).

According to the results of the survey, nearly one-third of respondents (30 percent) say prior authorization has caused adverse events, including emergency room visits, hospitalization, or permanent disability for their patients, with 7 percent reporting that it has led or contributed to the death of a patient in their care. Almost all radiation oncologists (92 percent) say that prior authorization causes treatment delays, which are experienced by more than one-third of their patients (35 percent). One-third of physicians say prior authorization has led to approximately one in 10 patients abandoning radiation treatment. Most physicians (58 percent) say prior authorization left them unable to adhere to established guidelines, and 82 percent say prior authorization has forced them to resort to a less optimal treatment than they originally prescribed. More than nine in 10 radiation oncologists agree that prior authorization either significantly or somewhat worsens staff burnout in their clinics, with eight in 10 doctors saying the prior authorization burden has grown worse in the past three years.

"These survey findings confirm what radiation oncologists witness daily: prior authorization policies are failing people with cancer, causing avoidable delays that are dangerous and, in too many cases, deadly," Howard M. Sandler, M.D., chair of the ASTRO Board of Directors, said in a statement.

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Disclaimer: Statistical data in medical articles provide general trends and do not pertain to individuals. Individual factors can vary greatly. Always seek personalized medical advice for individual healthcare decisions.

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