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The PA process is in many cases muddled by a mix of factors, including: Varying interests, workflows, and motivations of PBMs, patients and prescribers Loads of clinical protocols, each presenting the potential for delays and mistakes Manual reviews of prior authorization requests and medical charts by clinicians Lack of standardization among plan administrators and PBMs Hundreds of health plans and third-party payers Not All Prior Authorization Requests Are Reviewed by a Clinician on the PBM Side
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Emergent players include Hybio and Zhejiang Jiuzhou in China and SG Biopharm in South Korea, each leveraging localization incentives to sign offtake contracts with Western brand owners
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