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Barriers and Consequences of Prior Authorization for Neurologic Medications
Evelyn G. Gotlieb, Bamby Joseph, Leah J. Blank, Nathalie Jetté. JAMA Neurology, 2025-12-08
Topic: Risk, prevention and care in population studies
A total of 364 studies were identified using our search strategy on Ovid, 278 records were screened, and 20 studies were included in this review. The most frequently identified consequences for patients were delays in care (60%) and increase in disease activity (25%). The most frequently identified consequence for clinicians (35%) and administrators (15%) was time burden. The most common facilitators were the use of clinical pharmacists or technicians (20%) and health system specialty pharmacies (15%). Conclusions and Relevance: According to the results of this scoping review, PA can contribute to significant access barriers for people with neurological conditions and is associated with burden for all stakeholders involved. Reforms to PA can work towards more equitable access to medications for patients.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Gotlieb, E. G., Joseph, B., Blank, L. J., & Jetté, N. (2025). Barriers and Consequences of Prior Authorization for Neurologic Medications. JAMA Neurology. https://doi.org/10.1001/jamaneurol.2025.4560
Vancouver
Gotlieb EG, Joseph B, Blank LJ, Jetté N. Barriers and Consequences of Prior Authorization for Neurologic Medications. JAMA Neurology. 2025. doi:10.1001/jamaneurol.2025.4560. PMID: 41359327.
BibTeX
@article{gotlieb2025-41359327,
author = {Gotlieb, Evelyn G. and Joseph, Bamby and Blank, Leah J. and Jetté, Nathalie},
title = {{Barriers and Consequences of Prior Authorization for Neurologic Medications}},
journal = {JAMA Neurology},
year = {2025},
doi = {10.1001/jamaneurol.2025.4560},
pmid = {41359327},
url = {https://doi.org/10.1001/jamaneurol.2025.4560}
}
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
Key findings
- A total of 364 studies were identified using our search strategy on Ovid, 278 records were screened, and 20 studies were included in this review.
- The most frequently identified consequences for patients were delays in care (60%) and increase in disease activity (25%).
- The most frequently identified consequence for clinicians (35%) and administrators (15%) was time burden.
- The most common facilitators were the use of clinical pharmacists or technicians (20%) and health system specialty pharmacies (15%).
- Conclusions and Relevance: According to the results of this scoping review, PA can contribute to significant access barriers for people with neurological conditions and is associated with burden for all stakeholders involved.
Why it matters
This review found that prior authorization for neurologic medications can cause delays in care and increased disease activity, and it creates burden for clinicians and administrators. It does not test any treatment, cure, or prevention for Alzheimer's disease, and it suggests reforms to prior authorization could improve access to medications.
Study details
- Study designmeta-analysis
- Participants364
- Evidence strengthHigh
How this study scored 62/100
Published in a leading specialty journal, and it is a meta-analysis pooling many studies. Scored zero for effect reported because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (JAMA Neurology) |
| Journal's citation record | 2 / 4 | JAMA Neurology: journal h-index 235 (OpenAlex, 2026-10-29) |
| Study design | 12 / 12 | A meta-analysis pooling many studies |
| Strength of evidence | 5 / 5 | Rated “high” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 2 / 4 | 364 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | A review of other studies — randomisation is not credited here |
| Times cited | 2 / 7 | Cited 8 times (OpenAlex, 2026-10-10) |
| Citations per year | 1 / 5 | 2.7 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 3 / 6 | Cited 7.8× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 1 / 4 | Cited 8 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Nathalie Jetté: h-index 91 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | Icahn School of Medicine at Mount Sinai: institution h-index 1,331 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 5 institution(s) in 3 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 41359327) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 62 / 100 | — |
What each of these 20 components measures, and what this score is not →
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