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Between Scylla and Charybdis: medication preauthorization.(Issues in Urologic Nursing Practice)

Publication: Urologic Nursing

Publication Date: 01-JUN-04

Author: Quallich, Susanne A.
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COPYRIGHT 2004 Jannetti Publications, Inc.

Mike is a 28-year-old Type 1 diabetic who was diagnosed at age 17. He has recently gotten married, and he and his wife are trying to have a baby, but this is complicated by the fact that he has some degree of erectile dysfunction (ED) due to the diabetes. He seeks management for his ED and is given a prescription for an oral phosphodiesterase (PDE5) inhibitor. Yet the pharmacy is unable to fill his prescription, saying it is flagged for preauthorization because of the medication itself and because of Mike's age. Mike returns to his provider with the needed authorization forms, and eventually receives approval from his insurance company, 4 weeks after the original prescription was written, for a total of six pills per month.

According to the World Health Organization (WHO). "Sexual health is a state of physical, emotional, mental, and social well-being related to sexuality; it is not merely the absence of disease, dysfunction or infirmity. Sexual health requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences ... For sexual health to be attained and maintained, the sexual rights of all persons must be respected, protected and fulfilled" (WHO, n.d.). The WHO statement also includes the right to "pursue a satisfying, safe and pleasurable sexual life." These statements appear to be in direct conflict with the delay in treatment that resulted in Mike's case, particularly as the WHO statement clearly advocates the right to pursue sexual health.

Granting Permission

Preauthorization is the process by which a health...

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