Observational studyJournal of managed care & specialty pharmacy2026
Administrative costs of prior authorizations for glucagon-like peptide-1 agonists.
Observational study in Journal of managed care & specialty pharmacy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
7 authors.
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Abstract
backgroundPrior authorizations (PAs) help ensure appropriate prescription drug use but can be time-consuming for prescribers, clinic staff, and patients. Having a centralized, pharmacy-led PA process has shown significantly lower time to approval when compared with other decentralized models. However, the administrative impact of processing PA requests for glucagon-like peptide-1 (GLP-1) agonists prescribed for weight loss is unknown.
objectiveTo compare the total staff time spent on GLP-1 agonists prescribed for weight loss vs GLP-1 agonists for diabetes and other prescription medications.
methodsThis prospective observational study was conducted at UC Davis Health, a large academic health system from October 2024 to April 2025. Six licensed pharmacy technicians from a centralized pharmacy PA team participated in a self-reported time survey. PA tasks were categorized into 3 groups: (1) GLP-1 agonists for weight loss, (2) GLP-1 agonists for diabetes, and (3) top 10 non-GLP-1 agonist medications processed by volume at UC Davis Health. The primary outcome is defined as total hands-on time per PA, measured from PA initiation to removal from the pharmacy technician's work queue following the final decision by the third-party payer. A sample size of 50 PAs per group was selected based on projected mean PA process times of 10 minutes for weight loss GLP-1 agonists and 7 minutes for diabetes GLP-1 agonists (β = 0.2, α = 0.05). The Mann-Whitney U-test was applied to compare continuous variables (hands-on time, cost), whereas the Fisher's exact test was used for dichotomous variables (approval rate).
resultsA total of 150 PAs were collected. A self-reported time survey showed that weight loss GLP-1 agonists were associated with a significantly higher mean time per PA (7.1 minutes; 95% CI = 3.4-10.8;
conclusionsTotal hands-on time spent on GLP-1 agonists prescribed for weight loss was significantly longer compared with GLP-1 agonists for diabetes and other non-GLP-1 agonist medications. Additionally, GLP-1 agonists for weight loss had lower approval rates and higher cost per PA.
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