Heart failure & cardiomyopathies
Prior Authorization Requirements and Prescription Fill Patterns Among Patients With Heart Failure
Authors' conclusion
Prior authorization requirements were more common for patients identifying as Black or Hispanic and were associated with decreased and delayed filling of ARNI and SGLT2i. Our findings highlight an important barrier to mortality-reducing, guideline-recommended medications for HF.
Study context
- Population
- Patients with heart failure (HF) and a new prescription for ARNI or SGLT2i between April 1, 2021, and April 30, 2023, at a large, academic health systempatients, 1,243 with ARNI and 1,150 with SGLT2i prescriptions · ARNI 1,243 · SGLT2i 1,150
- Participants
- 2,183 patients
- Exposure
- Patients requiring prior authorization vs those not requiring it, for days to first fill and never filling ARNI or SGLT2i
- Outcome
- Prior authorization requirement
Methodological detailsinverse probability weighting
- Inverse probability weighting
Main finding
As reported in the abstract
ARNI, prior authorization requirement
12.2%
152/1,243
SGLT2i, prior authorization requirement
14.3%
165/1,150
Observational data: associations, not effects.
Further findings
| Outcome | Estimate | P value |
|---|---|---|
| Time to fill and never fillingPrior authorization requirement · weighted model | times longer to fill ARNI 3.03 (95% CI 2.16–4.25) | P < 0.001 |
| Time to fill and never fillingPrior authorization requirement · weighted model | times longer to fill SGLT2i 6.75 (95% CI 4.44–10.3) | P < 0.001 |
| Time to fill and never fillingPrior authorization requirement · weighted model | times more likely to never fill SGLT2i prescriptions 2.23 (95% CI 1.37–3.65) | P < 0.001 |
- Time to fill and never filling: all P < 0.001
Characteristics of patients requiring prior authorization
- Tended to be younger, identify as non-Hispanic Black or Hispanic, have non-Medicare insurance, and have fewer comorbidities
Original publication
Prior Authorization Requirements and Prescription Fill Patterns Among Patients With Heart Failure. JACC Adv. Published 24 January 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →