How Insurance Companies are Using the Internet to Influence Physician Prescribing.

As a result of rapid increases in the costs for outpatient prescription drugs, health insurance companies developed or contracted with pharmaceutical benefit management companies (PBMs) to perform a host of cost saving practices, including preapproval of prescriptions, before the drug is dispensed to the patient. Approval could be limited to the company's official list of approved drugs, or require significantly higher patient copayments for high cost drugs. Patients upset with non coverage or a high copayment were advised to contact the prescribing doctor and consider if a PBM-suggested alternative drug was acceptable. This paper explores how the growth and wide acceptance of the Internet, as well as resulting cost savings made possible the preapproval of outpatient drugs and how this practice may be affecting physician autonomy. ..PAT.-Unpublished Manuscript [ABSTRACT FROM AUTHOR]