AWIR is opposed to current utilization management tools prohibiting a patient from accessing a drug prescribed by their doctor until they fail on the preferred drug or set of drugs covered by their health plan. Preferred drugs are selected by Pharmacy Benefit Managers (PBMs) as a result of the rebate system and not based upon medical effectiveness. Many states do not have exceptions in place to bypass this process even when there is medical evidence proving the patient has already failed those drugs or they have a medical issue where it would be harmful for them to take that medication.