What is typically required for prior authorization in drug management?

Prior authorization in drug management typically requires a prior review of medical necessity by the insurer. This process is designed to ensure that the proposed medication is appropriate for the patient's condition, is effective for the intended use, and is being prescribed as a medically necessary treatment. The insurer evaluates the clinical information related to the drug request, which may include the patient's medical history, the prescribing physician's notes, and any relevant treatment guidelines.

Prior authorization helps manage costs, supports patient safety, and ensures adherence to evidence-based practices. It acts as a gatekeeping mechanism that helps control the usage of certain medications that may be high-cost or have potential risks involved. This requirement is a critical part of health insurance plans and directly impacts access to medications for patients.

The other options relate to different processes or requirements that do not specifically pertain to prior authorization. For example, a written prescription relates to the prescribing process itself, while a referral from a primary care physician refers to care coordination rather than medication approval. Pre-payment of drug costs is not commonly a requirement in the prior authorization process but may be linked to different aspects of healthcare billing.