Treatment, logistical, and cost burden of prior authorization in community practice.

164Background: Prior authorization (PA) process is complicated and labor intensive and with limited resources available to community practices, significant opportunity to reduce the costs of therapy exists by transforming this decision support process while being compliant with guidelines Methods: We retrospectively evaluated 123 patients between November 2016 and June 2016 across our three rural oncology practices with no dedicated in-house pharmacy. An established PA workflow involved two physicians, 1 nursing staff and 2 clerical staff involved in the process to manage PA for high cost imaging (PET/CT/MRI) or after a high-risk/cost prescription was initiated by a medical provider to a local pharmacy, specialty or mail-order pharmacy. Two Physicians determined strength of concordance with National Comprehensive Cancer Network (NCCN) guidelines. We examined approval rates, method of communications, time to approval and whether these variables were associated treatment delay and insurance provider Results...