BACKGROUND: Glucagon-like peptide 1 receptor agonists (GLP-1 RAs) have gained popularity because of their demonstrated efficacy in weight loss, resulting in access barriers such as delays due to prior authorizations (PAs), insurance coverage restrictions, and limited availability. The national average for PA turnaround times is currently 72 hours. To offer solutions to these barriers, the University of Colorado Hospital (UCHealth) has integrated a pharmacy team into their primary care practice setting to provide specialized support to enhance access.
OBJECTIVE: To evaluate how pharmacist-led interventions affected PA turnaround times for GLP-1 RAs prescribed for weight loss. Additionally, we aimed to characterize these interventions to better understand the pharmacist's role in integrated care teams for weight management.
METHODS: This retrospective cohort study used UCHealth electronic health records to evaluate pharmacist-led interventions identified by multistep order transmittal workflow in September 2024. The primary endpoint was PA turnaround time. The secondary endpoints included time to GLP-1 RA initiation, qualitative assessments of pharmacist-led interventions, and dosing optimizations. Survival analyses and descriptive analyses were conducted for time-to-event and qualitative endpoints.
RESULTS: A total of 142 patients were included in this study. Fifty-six patients were observed in the PA-approved group and 86 patients in the PA-denied group. The median turnaround time for any PA decision was 19.87 hours (95% CI = 6.88-23.58). PA approvals had a median turnaround time of 47.1 hours (95% CI = 23.4-69.6), whereas PA denials had 3.6 hours (95% CI = 2.4-16.7) ( = 0.0072). Documented interventions included patient updates on PA status, insurance plan criteria reviews, provider collaboration, alternative therapy recommendations, copay resources, insurance outreach, and dose clarification. P
CONCLUSIONS: Integrating pharmacists into care teams can enhance GLP-1 RA PA turnaround times while improving medication access, safety, and continuity of care. These findings support further research and policy development in pharmacist interventions in PA process and GLP-1 RA management.
