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Insurance Red Tape Delays Crucial Heart Failure Drug Prescriptions, Study Finds
- March 17, 2026
- Dennis Thompson HealthDay Reporter
Insurance requirements could keep people from getting life-saving heart medications in a timely fashion, a new study says.
Prescriptions for heart failure medications take two to six times longer to fill if insurance companies require prior authorization — a process that requires doctors to obtain insurers’ approval before a treatment is covered, researchers reported in the journal JACC: Advances.
Many patients eventually throw up their hands, never bothering to start taking heart drugs that doctors think could save their lives and keep them out of an ER, researchers said.
“Our results suggest that prior authorization may be doing harm when it comes to guideline-recommended medications with no generic alternatives,” said lead researcher Dr. Amrita Mukhopadhyay, an assistant professor of cardiology at NYU Grossman School of Medicine in New York City.
“While these policies are meant to control health care costs by steering patients toward lower-priced alternatives, they may instead be keeping people with heart failure from timely access to lifesaving treatments,” Mukhopadhyay said in a news release.
Most patients fill prescriptions the same day as their medical visit, researchers said in background notes. If the pharmacy tells them they have to wait for weeks, some might give up on the treatment.
For the new study, researchers tracked nearly 2,200 men and women receiving treatment for heart failure at NYU Langone Health.
The team tracked new prescriptions between 2021 and 2023 of angiotensin receptor-neprilysin inhibitors (ARNIs) and sodium-glucose cotransporter-2 (SGLT2) inhibitors — newer drugs that are considered the pillars of modern heart failure treatment.
Those two drugs have no generic alternatives and can cost hundreds of dollars out of pocket, researchers said. Prior research has shown that less than half of patients prescribed these meds take them regularly.
Results showed that patients whose prescriptions needed prior authorization took three times as long to fill an ARNI, and up to six times longer to fill SGLT2 inhibitors.
As a result, twice as many heart patients who needed prior authorization wound up never filling their prescription for an SGLT2 inhibitor, researchers said.
Prior authorization was more common among people living in poorer neighborhoods, people identifying as Black or Hispanic, and people on Medicaid.
“Our results indicate that prior authorization requirements may be contributing to the substantial health disparities seen in heart failure care and need to be carefully reexamined,” senior researcher Dr. Saul Blecker, an associate professor at NYU Grossman School of Medicine, said in a news release.
The team next plans to explore how cost-sharing measures like copays and coinsurance affect access to heart failure drugs.
More information
The RAND Corporation has more on prior authorization.
SOURCE: NYU Langone Health, news release, March 11, 2026
