The Pain of Prior-Auths

I hate filling out medication prior-authorization forms! Luckily I don’t have to do it much since I usually prescribe generics. However, sometimes using name brand medications is unavoidable. For instance, I have one patient who is on Celebrex for osteoarthritis. She had serious GI side effects with traditional NSAIDs. And because NSAIDs may reduce the efficacy of aspirin (which the patient is taking), we decided to stick with Celebrex. SO EVERY STINKING YEAR FOR THE PAST FIVE YEARS, I go through the same song-and-dance with her insurance company. It is an unnecessary AND time-consuming AND irritating job. This last round, I wrote this on the bottom of the form:

PLEASE APPROVE HER CELEBREX FOR MORE THAN ONE YEAR!!!!! HER HISTORY DOES NOT CHANGE FROM YEAR TO YEAR!!!!  AND THIS IS AN UTTER AND COMPLETE WASTE OF MY TIME!!!! STOP BOTHERING ME!!!!!

My MA looked at me with some skepticism before faxing the form. Two weeks went by with no reply. Then I got this faxed back from the prescription management company:

CONGRATULATIONS! We have approved your patient’s Celebrex for 6 MONTHS!

Nice!!!!! I must admit though—instead of being fuming mad—I thought this was a brilliant response. Six months! That must be the best passive-aggressive response I have ever heard! I showed the fax to my partner who just laughed. I should have kept it. Then, I could frame it. Actually I should have kept faxing back the same form! Maybe I could get it down to 6 days!