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Atul_Gawande's profile
Atul Gawande
Atul Gawande
Atul Gawande
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@Atul_Gawande

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Atul GawandeVerified account

@Atul_Gawande

Surgeon, Writer, Researcher, Dilettante. https://www.ariadnelabs.org/  http://www.lifebox.org/ 

atulgawande.com
Joined January 2011

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    Atul Gawande‏Verified account @Atul_Gawande Apr 27

    Insurers don't refuse to pay for narcotics without prior authorization. But they do for medication-assisted treatment.https://wapo.st/2r34YQM 

    7:25 AM - 27 Apr 2018
    • 72 Retweets
    • 99 Likes
    • David Lakshman Swamy Brian Barnett 🇮🇱  Neener 🍂 Gitte Pedersen Brian Barnett Chris Amidon Dan Rusyniak IBC Research Fdn
    11 replies 72 retweets 99 likes
      1. Mary Dunne‏ @MimiDunneMD Apr 27
        Replying to @Atul_Gawande

        Hello, @Atul_Gawande. Are you kidding? Getting prior auths for cancer pts w pain is the bane of my pal care existence.

        0 replies 1 retweet 1 like
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      1. SUD Institute‏ @USciences_SUDI Apr 27
        Replying to @Atul_Gawande

        Pricier branded opioids do have prior auths with many plans, i.e. the long-acting ones, especially some abuse-deterrent formulations. In the past, the inexpensive generic short-acting opioids did not, but that is starting to change to enforce new RX guidelines.

        0 replies 0 retweets 3 likes
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      1. George Dawson‏ @dawso007 Apr 27
        Replying to @Atul_Gawande

        Have also done PAs for opioids including hospital discharges when the patient was admitted on the same maintenance opioids for chronic pain. Insurers make it hard to treat anybody but the evidence is clear - much harder for anyone with mental illness or addiction.

        0 replies 0 retweets 3 likes
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      1. Adam C Lake MD‏ @ACLakeMD Apr 27
        Replying to @Atul_Gawande

        I’ve done PAs for both, can count on one hand how many times its changed mgmt. need to take off my shoes to show how many hours I’ve spent related to these... just over a few months...

        0 replies 0 retweets 3 likes
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      2. Nick Sawyer‏ @NickSawyerMD Apr 27
        Replying to @Atul_Gawande

        Publicly traded for-profit health insurers have a fiduciary (legal) responsibility to prioritize shareholder profits over patient and physician wellness. This is antithetical to any healthcare system and is nearing its breaking point.pic.twitter.com/V50lpuHdlC

        1 reply 0 retweets 2 likes
      3. 1 more reply
      1. L.E. Marcus‏ @ellie_mint Apr 27
        Replying to @Atul_Gawande

        Neither the Rx for 4 days of opiates written by the discharge M.D. when my friend left the hospital post hip replacement 2 days after surgery nor the follow up Rx written by the surgeon were paid for by the Ins. Co. because of no prior auths. this for an opiate naïve patient.

        0 replies 0 retweets 1 like
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      1. Steven Lawrence Meye‏ @MeyerStevenL Apr 27
        Replying to @Atul_Gawande

        You cannot let physicians off the hook. How did a group of supposedly scientifically trained professionals fall for the hype about the safety of opioids? Aren't doctors supposed to demand evidence before embarking on a prescription spree?

        0 replies 0 retweets 0 likes
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      2. Kurt Christensen‏ @projectileboy Apr 27
        Replying to @Atul_Gawande

        But absolutely, the health industrial complex is only fundamentally concerned with human welfare, and is absolutely not influenced by the incentive to maximize profits.

        1 reply 0 retweets 0 likes
      3. Matt Smith‏ @Peccavi_ultum Apr 27
        Replying to @projectileboy @Atul_Gawande

        THAT'S SARCASM, RIGHT ??

        0 replies 0 retweets 0 likes
      4. End of conversation
      1. Dania Palanker‏ @DaniaPal Apr 27
        Replying to @Atul_Gawande

        This is a prior authorization form for opioids from Optum https://professionals.optumrx.com/content/dam/optum3/professional-optumrx/resources/pdfs/ORxCommForms/Short-ActingOpioids_Comm.pdf …

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      2. Meg Carter‏ @meg_in_richmond Apr 27
        Replying to @Atul_Gawande

        I think prior auth is primarily about cost. Opoids are very inexpensive under most insurance plans (<$5 for standard prescription) because they're off-patent & generics exist. For manufacturers, big money is in chronic pain patients. Treatment is much newer & likely to be costly.

        1 reply 0 retweets 0 likes
      3. Matt Smith‏ @Peccavi_ultum Apr 27
        Replying to @meg_in_richmond @Atul_Gawande

        Most CPPs I know always try to stay on generics to save $$$ , most have serious financial stress.

        0 replies 0 retweets 0 likes
      4. End of conversation

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