TABLE 1.
Outcome Comparison
| Refill (n=45) | PCN (n=68) | P Valuea | Estimated Between Group Difference (95% CI) | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| N | % | Mean | SD | Median | Range | N | % | Mean | SD | Median | Range | |||
| Average PA approval rate (%) | 45 | 93 | 68 | 68 | 0.0018 | 26.00 (12.00-40.00) | ||||||||
| Average PA process time (days) | 45 | 0.53 | 0.8 | 0.0 | (0-4) | 62 | 7.02 | 12.8 | 4.0 | (0-81) | 0.0001 | 6.72 (3.41-10.02) | ||
| Average time to fill (days) | 39 | 2.49 | 5.6 | 1.0 | (0-28) | 31 | 5.52 | 6.59 | 4.0 | (0-27) | 0.0230 | 3.33 (0.52-6.73) | ||
| Average time to pick-up (days) | 35 | 4.26 | 7.0 | 2.0 | (0-29) | 26 | 8.08 | 8.15 | 6.0 | (0-29) | 0.0290 | 4.60 (0.40-8.71) | ||
| Prescriptions picked up (%) | 39 | 92 | 37 | 76 | 0.0562 | 17.00 (-0.40-34.00) | ||||||||
| Total staff time spent on PA (minutes) | 45 | 15.3 | 5.6 | 14.0 | (3-27.5) | 19 | 63.8 | 41.6 | 52.0 | (18-185) | < 0.0001 | 48.74 (29.07-68.40) | ||
| Cost / PA ($)b | 45 | 11.5 | 4.2 | 10.5 | (2.3-20.6) | 19 | 37.5 | 25.5 | 30.2 | (12-122) | < 0.0001 | 26.13 (14.05-38.21) | ||
| Commercial insurance | 31 | 70 | 56 | 85 | ||||||||||
| Medicare Part D | 13 | 30 | 10 | 15 | 0.0940 | |||||||||
a P values were controlled for insurance type using the Cochran-Mantel-Haenszel test for “PA approval rate” and “Prescriptions picked up rate.” For continuous outcomes, P values and 95% CIs were estimated using the generalized linear mixed model with heteroscedasticity-robust sandwich estimator. The chi-square test was used to determine insurance differences between the 2 groups. Commercial insurance included 4 plans, and Medicare Part D included 8 plans.
b Cost/PA ($) was estimated based on average salary and benefits for the employee involved in the PA.
CI = confidence interval; PA = prior authorization; PCN = primary care network (usual care); Refill = refill clinic (intervention); SD = standard deviation.