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After a request comes in from a qualified provider, the request will go through the prior authorization process. The process to obtain prior authorization varies from insurer to insurer but typically involves the completion and faxing of a prior authorization form; according to a 2018 report, 88% are either partially or entirely manual.
Express Scripts Holding Company is a pharmacy benefit management (PBM) organization. In 2017 it was the 22nd-largest company in the United States by total revenue as well as the largest pharmacy benefit management (PBM) organization in the United States. [2] Express Scripts had 2016 revenues of $100.752 billion. [2]
With e-prescribing, renewal authorization can be an automated process that provides efficiencies for both the prescriber and pharmacist. Pharmacy staff can generate a renewal request (authorization request) that is delivered through the electronic network to the prescriber's system.
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Surescripts is an American information technology company based in Arlington, Virginia that supports e-prescription, the electronic transmission of prescriptions between health care organizations and pharmacies, as well as general health information exchange (HIE) of medical records. [1]
According to the 2014 Express Scripts Drug Trend Report, [51] the most significant increase in prescription drugs in the United States in 2014 was due to "increased inflation and utilization of hepatitis C and compounded medications". [51] "Excluding those two therapy classes, overall drug spend would have increased only 6.4%. [51]
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