Proactive Interventions for the Prior Authorization Process-How to Make the Pharmacy Your Prior Authorization Ally

Video Transcription

Video Summary

The webinar, hosted by the Association of Community Cancer Centers, focused on how pharmacy teams can support the prior authorization process in oncology. Speaker Andre Harvin, Executive Director of Pharmacy for Oncology at Cone Health, argued that pharmacy should be treated as a collaborator to help reduce delays, manage biosimilar transitions, improve medical necessity documentation, and lessen financial toxicity.<br /><br />He discussed the rising cost of cancer care and the burden prior authorization places on patients and clinics. Harvin reviewed evidence showing that prior authorization can shift prescribing toward preferred therapies, but can also delay treatment and contribute to care abandonment. He then explained practical ways pharmacy can help, especially with biosimilars, where payer preferences, reimbursement, and coding often vary by product and plan.<br /><br />Key strategies included pharmacist-led therapeutic substitution policies, financial margin analyses to choose the best reimbursed biosimilar, and coordination with patient assistance programs. He also highlighted pharmacist involvement in step therapy for IV iron, denial management, and reducing waste-related billing issues.<br /><br />Throughout the session, Harvin emphasized breaking down silos between pharmacy, prior authorization, billing, and clinicians. His main message: teamwork and proactive collaboration are essential to navigating increasingly complex cancer care processes.

Asset Caption

In the second webinar, we will hear from Andre D. Harvin, PharmD, MS, Executive Director of Pharmacy for Oncology at Cone Health. We will discuss how your pharmacy team can be a major ally and support in obtaining prior authorizations, help navigate biosimilar changes, and address medical necessity.

Keywords

prior authorization

oncology pharmacy

biosimilars

cancer care costs

financial toxicity

therapeutic substitution

patient assistance programs

step therapy

denial management