Prior authorization requires a pre-approval from a patient’s health insurance company before medical care can be covered and/or reimbursed. These requirements should not undermine or delay patient access to medically necessary care. For individuals with cancer, treatment delays may lead to irreversible disease progression.

Unfortunately, a 2022 survey of ASCO members found that nearly all participants report a patient has experienced harm because of prior authorization processes, including significant impacts on patient health such as disease progression (80%) and loss of life (36%). The most widely cited harms to patients reported are delays in treatment (96%) and diagnostic imaging (94%); patients being forced onto a second-choice therapy (93%) or denied therapy (87%); and increased patient out-of-pocket costs (88%).​

Read the full survey summary.

ASCO has long advocated for prior authorization reforms that address care delays and harms to patients. Since 2018, the Association has advocated for the passage of the Improving Seniors’ Timely Access to Care Act, which would streamline prior authorization in Medicare Advantage. Urge your lawmakers to enact legislation that protects patients' access to timely care. It only takes seconds on the ACT Network.

Additional Resources:

ASCO Survey Summary on the Impact of Prior Authorization on Cancer Care

ASCO Position Statement: Prior Authorization

ASCO Launches Campaign Urging Congress to Pass Prior Authorization Reform

Media Issue Brief: Utilization Management Policies