Let's Talk Nursing Now

Let's Talk Nursing Now A proactive social media, advocacy, policy and lobbying organization supporting the largest female-dominated profession- nursing....

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A registered nurse going thru treatment and sharing her experiences….
05/23/2026

A registered nurse going thru treatment and sharing her experiences….

Physicians without subject-matter expertise routinely conduct prior authorization reviews, creating barriers that reinfo...
05/19/2026

Physicians without subject-matter expertise routinely conduct prior authorization reviews, creating barriers that reinforce denials of necessary care. These delays frequently lead to adverse events, shortened lives, and increased costs for insurers, as untreated patients later require expensive, emergency interventions for complications.

According to data from the American Medical Association, roughly one-third of physicians report that prior authorization requests are often or always denied, with 94% stating that these restrictions delay access to necessary care. Furthermore, nearly a quarter of physicians state these prior authorizations have led to serious adverse events for their patients, including permanent disability or death. Ironically, by enforcing rigid utilization protocols and denying evidence-based medicine, insurers drive up long-term medical costs. When patients abandon recommended treatments, their conditions deteriorate, resulting in more costly hospitalizations and complex medical interventions.

This dynamic is clearly evident in the utilization of GLP-1 (glucagon-like peptide-1) receptor agonists. Despite overwhelming clinical data showing that long-term use of GLP-1 medications can safely reverse pre-diabetes and prevent the onset of Type 2 Diabetes, these drugs routinely face strict prior authorization requirements and coverage denials from insurers. Insurers often point to the high upfront cost of GLP-1s, which can range from $10,000 to $16,000 annually. However, restricting access to these preventive medications ultimately results in far higher expenditures. The average annual cost of caring for a patient with Type 2 Diabetes is massive, often exceeding the medication costs when factoring in emergency treatments, dialysis, heart disease, and long-term complications. Five years out, the cost of caring for a compliant diabetes patient starts to exceed GLO patient costs. By denying coverage for GLP-1s, insurers avoid short-term pharmaceutical expenses only to guarantee long-term financial liabilities and worsened patient outcomes.

Until insurers rethink their model, comprehensive medical care remains compromised by denials of medical authorizations by physicians without expertise in the care requested; and blanket denials of certain meds and procedures not backed by evidence-based medicine.

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