New Optum Product Helps Companies Better Manage Pharmacy Costs

October 18, 2012
  • ProtectRx caps client liability for covered pharmacy benefit costs

OptumRx, a leading pharmacy benefits management (PBM) organization and one of the Optum businesses of UnitedHealth Group (NYSE: UNH), has launched a new product designed to help keep pharmacy benefit costs predictable for clients. ProtectRx is an aggregate stop loss (ASL) insurance product that is being offered in addition to a standard PBM agreement with OptumRx to health plan sponsors.

As prescription drug costs continue to rise, many self-insured clients are seeking options to mitigate the financial risk and volatility of drug costs. ProtectRx ASL insurance, which is offered as a supplement to a standard OptumRx PBM agreement, caps client liability for total pharmacy benefit costs for a full policy year. This special coverage reimburses companies if annual pharmacy benefit costs exceed a designated level, which is calculated based on the client’s unique pharmacy plan, claims history, member demographics and other factors.

“ProtectRx eliminates the potential for surprises, allowing organizations to better plan for and manage their pharmacy costs and reduce overall health care costs, while providing excellent benefits,” said Margaret Wear, OptumRx senior vice president and chief actuary. “This product provides clients advance knowledge of the maximum claims costs they will be responsible for and reduced overall liability.”

ProtectRx delivers savings protection, predicted spend levels and insight on drug claims using a state-of-the-art drug calculation model on top of OptumRx’s award-winning drug monitoring and disbursement programs. The client pays a monthly premium for the ASL policy in addition to payments made under the standard PBM agreement. The policy must be renewed annually.

The new product is being rolled out nationwide for a Jan. 1, 2013, effective date.

About OptumRx

OptumRx is part of Optum, a leading information and technology-enabled health services company dedicated to making the health system work better for everyone. OptumRx is an innovative pharmacy benefit management business managing the prescription drug benefits of commercial, Medicare and other governmental health plans, as well as those of employers and unions through a national network of 64,000 community pharmacies and state-of-the-art mail service pharmacies in California and Kansas, both of which have earned the prestigious Verified Internet Pharmacy Practice Sites™ (VIPPS®) accreditation by the National Association of Boards of Pharmacy®. Visit or for more information.

About Optum
Optum ( is a leading information and technology-enabled health services business dedicated to helping make the health system work better for everyone. Optum comprises three companies – OptumHealth, OptumInsight and OptumRx – representing more than 35,000 employees worldwide who collaborate to deliver integrated, intelligent solutions that work to modernize the health system and improve overall population health. 

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