I had an annoying experience with prior authorizations. Insurance required prior authorization for Cymbalta about 4 months ago. I called and insurance said pharmacy was billing something like $325 for a month of 60 mg Cymbalta. I called the pharmacy and they told me the cash price was $30 each month. After wasting 20 minutes on the phone with the insurance company arguing about why they can't just pay the $30 price, I told the patient to just pay cash. What really bothers me is the pharmacy charging way more to the insurance company, which is most likely why the prior authorization was required. Then the pharmacy calls me and tells me to do the prior authorization. If I could do it over again, or if I have to deal with this pharmacy again, I would tell them to do the prior authorization if they are charging a premium to the insurance company.