What is the purpose of requiring pre-approval for certain medications?

Requiring pre-approval for certain medications primarily serves the purpose of ensuring that the drug prescribed is appropriate for the patient’s specific health conditions, particularly for those who are Medicare-eligible. This process allows healthcare providers to justify the use of a medication based on established clinical guidelines, ensuring that the prescribed treatment aligns with the patient's diagnosis and is deemed medically necessary.

By assessing the appropriateness of a medication, insurance plans can help optimize patient outcomes, ensuring that the prescribed therapies are effective for the particular conditions being treated. This can prevent unnecessary medications from being used, which not only safeguards the health of patients but also helps in managing overall healthcare costs.

The other options, although they might address aspects of healthcare management, do not encapsulate the primary intention of the pre-approval process in the same way. Mitigating pharmacy costs is a broader financial management issue and does not directly relate to evaluating patient care or treatment appropriateness. Increasing profitability for insurance plans is more about business objectives rather than patient care standards. Limiting the number of prescriptions written may seem connected, but the focus should be on the quality and appropriateness of treatment rather than the quantity of prescriptions.