Prior authorization.

It may be killing more than your soul. Time spent between learning you have cancer to initiating treatment is something a lot of patients stress about. But should they? A recent NCDB analysis suggests, actually, yes. This time interval between diagnosis and treatment start date was measured for over 3.6 million patients treated for breast, prostate, colorectal, lung, renal and pancreatic cancers between 2004 and 2013. The bad news is the median time interval significantly increased over time from 3 weeks in 2004 to over 4 weeks in 2013. The worse news is that an increased time interval was significantly associated with worse survival in a continuous fashion across all cancers except, you guessed it, prostate cancer. Longer delays in treatment start happened more often with the usual demographic suspects but, ironically, also for those treated in academic settings. But, hey, at least they had results of their genetic testing before deciding on standard of care treatment. TBL: For most cancers, delays in treatment start decrease relative survival by 1-3% per week—so add that to the list of reasons prior auths and extraneous testing shouldn’t delay things further. | Khorana, PLoS One 2019