IQVIA Study Finds High Medicare Part D Denial Rates for New Chronic Condition Medications

A study by IQVIA highlighted by the U.S. trade association PhRMA reveals that Medicare Part D plans frequently deny patients access to their prescribed medications for newly diagnosed chronic conditions. In particular, over 70% of patients experienced immediate denials in four out of five studied therapeutic areas including osteoporosis, immunology, multiple sclerosis, migraine, and pulmonary arterial hypertension. Patients typically endured two to three levels of rejection before approval, with some facing over 11 denials, indicating significant barriers to timely medication access. These findings underscore critical challenges in payer policies and prior authorization processes within Medicare Part D, impacting patient outcomes and healthcare compliance.