IQVIA’s white paper shows that Medicare Part D patients face significant barriers from formulary controls such as prior authorization, step therapy, and exclusions. Across five chronic therapeutic areas—PAH, osteoporosis, MS, immunology, and migraine—over half of patients were initially denied coverage, with rates exceeding 70% in four areas. Those who overcame rejections faced delays of 14–24 days and multiple attempts, with some enduring 11+ rejections. After a year, 18–42% still lacked approval, and 68–80% of these patients did not start any new treatment, highlighting how payer controls disrupt access and care continuity.

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