Findings from Johns Hopkins University Bloomberg School of Public Health Broadens Understanding of Health and Medicine (Prior Authorization and Associated Delays and Denials of Branded Medication Dispensation): Health and Medicine

2026 APR 23 (NewsRx) -- By a News Reporter-Staff News Editor at NewsRx Policy and Law Daily -- Investigators publish new report on Health and Medicine. According to news reporting originating in Baltimore, Maryland, by NewsRx journalists, research stated, “Prior authorization (PA), a practice used by health insurance companies in the US to control care utilization, may create barriers for treatment delivery. Less is known regarding its impact on delaying and denying prescription medication dispensing.”

The news reporters obtained a quote from the research from the Johns Hopkins University Bloomberg School of Public Health, “To examine PA processing times and approval rates for branded medication prescriptions that are initially rejected, and to assess key factors associated with variations in these outcomes. This cross-sectional study used 2024 IQVIA pharmacy claims data to identify branded drug dispensations that faced initial PA rejections and completed the PA adjudication process. The frequencies of same-day processed PA reviews and the final approval rates were calculated. They were then stratified by number of PA reviews, additional rejection reasons, refill status, days of supply, prescribers’ ownership, insurance market segment, and patient characteristics. Logistic regressions were performed to estimate the association between these factors and the likelihood of same day processing and final approval. Data were analyzed from July to December 2025. Branded medication dispensations after initial PA rejections. Percentage of same-day processed, and ultimately approved prescription medication dispensations. The analysis included 205 896 branded medication dispensations that faced initial PA rejections from 156 848 patients (mean [SD] age, 55 [14] years; 109 227 females [70%] and 47 621 males [30%]) in the US. Of the total dispensed, 71 324 (35%) prescriptions were processed in 1 day, and the remaining 134 572 (65%) were processed during a median (IQR) of 6 (3-12) days. Of these, 111 758 (54%) were eventually approved. Medication prescriptions with multiple rounds of PA reviews, additional rejection reasons, or refills were associated with 37% (95% CI, 37%-37%), 39% (95% CI, 38%-39%), and 9% (95% CI, 9%-10%) lower probability of same-day processing, respectively. Medication fills from Medicaid patients or patients with multiple disease conditions had 8% (95% CI, 7%-8%) and 5% (95% CI, 4%-5%) lower approval rates, respectively. This cross-sectional study suggests that most patients filling prescriptions that PA initially rejected experienced treatment delays and/or eventual denials.”

According to the news reporters, the research concluded: “Claim adjudication complexity, prescription type, and patient characteristics were associated with these outcomes.”

For more information on this research see: Prior Authorization and Associated Delays and Denials of Branded Medication Dispensation. JAMA Health Forum, 2026;7(4). JAMA Health Forum can be contacted at: Amer Medical Assoc, 330 N Wabash Ave, Ste 39300, Chicago, IL 60611-5885, USA.

Our news correspondents report that additional information may be obtained by contacting Joseph F. Levy, Dept. of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland. Additional authors for this research include Yang Wang, T. Joseph Mattingly and Gerard Anderson.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.1001/jamahealthforum.2026.0760. This DOI is a link to an online electronic document that is either free or for purchase, and can be your direct source for a journal article and its citation.

The publisher of the journal JAMA Health Forum can be contacted at: Amer Medical Assoc, 330 N Wabash Ave, Ste 39300, Chicago, IL 60611-5885, USA.

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