The Pharmacist's Guide to Prior Authorization & Utilization Management
What They Don't Teach You in Pharmacy School
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Pharmacy school teaches the science. It rarely teaches how coverage decisions actually get made — the mechanics of prior authorization, step therapy, formulary tiers, appeals, and the broader world of utilization management that shapes what patients can actually access.
This 12-chapter clinical reference walks through that system in plain terms: how PA and UM decisions are made, how step therapy and appeals actually work, how Medicare Part D fits in, and what a career path into managed care pharmacy looks like from the inside.
- 12 chapters covering PA, UM, step therapy, appeals, and Medicare Part D
- A practical look at managed care pharmacy career paths
- By Adetayo Ogunsanya, PharmD
METHUVIA AI — Pharmacist-Guided Prior Authorization
I'm building an AI-assisted PA adjudication platform where the engine surfaces recommendations, but a licensed pharmacist makes every final coverage decision — not the other way around.
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