!!! CASE STUDY: FIRSTPASSRX !!!

FirstPassRx

LIVE Skipping the prior-authorization round-trip, one cited formulary at a time

Source: FirstPassRx
Website: https://pranava0x0.github.io/FirstPassRx/

Background

The question that set this off: when a prescriber picks a drug the patient's plan doesn't prefer, why does everyone eat a prior-authorization round-trip — and could you avoid it just by knowing what the plan already covers?

A prior authorization is the fax-and-phone-tree detour that kicks in when a prescription isn't on the plan's preferred list: days of back-and-forth while the patient waits, often to land on a drug the plan would have covered on the first pass. The information needed to skip it already exists — it's sitting in the plan's own formulary — but that formulary is a PDF that changes quarterly and nobody reads at the point of care. FirstPassRx asks one narrow question: for this plan and this kind of prescription, what's the agent the plan already prefers, so the first script goes through clean? It's a reference tool, not a treatment recommender — patient-specific clinical selection and dosing stay with the prescriber.

How It Works

It's a static single-page app that turns published formularies into a three-step lookup — pick a plan, pick a prescription type, read the first-pass answer:

Four guides, one interface: a top toggle switches between guides, each a region × therapeutic area with its own plans, drug classes, and sourced data — Massachusetts inhalers, Maryland menopause hormone therapy, New York ACE inhibitors, and Virginia diabetes. Pick the exact benefit product and the class of drug you're writing for.
What it returns: the formulary's first-pass agent (the one least likely to trip a prior auth), the covered alternatives, the true coverage barriers — step therapy, quantity limits, brand-over-generic rules — and indicative GoodRx / Cost+ pricing so cost is on the same screen as coverage.
A citation on every claim: each result carries a numbered source citation back to the plan's own drug list (MassHealth MHDL, payer PDLs, plus FDA and clinical-guideline sources), and every data point is tagged verified, partial, or example so you know exactly how much to trust it. Because formularies drift quarterly, a provenance gate re-checks every cited source and flags any that have moved or 404'd.
When the answer is still "no": if the preferred agent doesn't fit, the tool drafts a plan-specific appeal letter to start the exception on the right foot.
Built to be audited, not trusted on faith: a React + Vite single-page app with no backend, deployed to GitHub Pages, whose test suite gates every visible coverage or restriction claim on a correct, claim-specific source before it can ship. It's a reference, not medical advice — confirm every agent and restriction against the linked source before prescribing.

[View the Live App] | [View the Code]

A Look Inside

Each view shown on mobile and desktop — tap any image to open the live site.

Pick an insurance plan and a prescription type, and the tool returns that plan's first-pass agent (mobile) — Pick an insurance plan and a prescription type, and the tool returns that plan's first-pass agent — the drug least likely to trigger a prior authorization — alongside covered alternatives, the real coverage barriers, and a numbered source citation on every claim.

Pick an insurance plan and a prescription type, and the tool returns that plan's first-pass agent (desktop) — Pick an insurance plan and a prescription type, and the tool returns that plan's first-pass agent — the drug least likely to trigger a prior authorization — alongside covered alternatives, the real coverage barriers, and a numbered source citation on every claim.

A top toggle switches between guides, each a region × therapeutic area with its own plans and sourced formulary data (mobile) — A top toggle switches between guides, each a region × therapeutic area with its own plans and sourced formulary data — now spanning Massachusetts inhalers, Maryland menopause hormone therapy, New York ACE inhibitors, and Virginia diabetes.

A top toggle switches between guides, each a region × therapeutic area with its own plans and sourced formulary data (desktop) — A top toggle switches between guides, each a region × therapeutic area with its own plans and sourced formulary data — now spanning Massachusetts inhalers, Maryland menopause hormone therapy, New York ACE inhibitors, and Virginia diabetes.

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