Optum Rx is an advocate, driving value, client transparency and consumer choice across the pharmacy supply chain, delivering significant cost savings and better outcomes and experiences for millions of people.
Our unique tools and innovative programs help members access the lowest prices.
- PreCheck MyScript allows doctors to see real-time pricing during an office visit, which enables them to prescribe the most cost-effective options for their patients – saving an average of about $111 per script.
- Optum Perks is available to allow members to access the best cash price at more than 67,000 pharmacies.
- Price Edge seamlessly compares available direct-to-consumer pricing for traditional generic drugs with insurance pricing to ensure members always get the lowest prescription drug price.
- We were first in market to offer multiple biosimilars on our formulary for Humira, giving patients and their doctors the ability to make decisions based on their individualized needs, while ensuring access to a broader set of effective therapies and lowering costs to payers.
We negotiate rebates and discounts off of high list prices set by drug manufacturers and pass those savings to clients.
- On average, Optum Rx passes through 98% of the discounts and the pharmacy rates we negotiate to our customers.
Optum Rx is empowering clients and consumers to choose the benefits that meet their specific needs and lowering costs for their whole populations.
- We’re providing cost predictability to stabilize and improve the predictability of pharmacy benefit budgets.
- We’re offering our clients multiple options for pharmacy network reimbursement, including spread, pass-through and National Average Drug Acquisition Cost (NADAC) models.
Optum Rx integrates pharmacy, medical and behavioral care services to provide affordable access to prescription medications and therapies, delivering a better experience for consumers, providers and payers and outcomes for patients.
Learn more about the key components of our comprehensive pharmacy services offerings.
Genoa Healthcare
Genoa Healthcare provides pharmacy and clinical services for individuals with behavioral health and other complex chronic health conditions.
- Serving 1 million people annually across more than 700 locations in the U.S., most of Genoa’s pharmacies reside within community mental health centers to serve patients in the same facilities where they receive care.
- Medication adherence rate of more than 90%, compared to 50% at most retail pharmacies.
- Patients using Genoa pharmacies experience 40% fewer hospital stays and 18% fewer emergency room visits.
Cost Made Clear
Offers expanded payment options that enable choice and drive transparency and affordability in pharmacy benefits to the employer, union and health plan customers we serve. In addition to traditional and pass-through payment solutions Optum Rx offers today, we now offer additional solutions, including:
- Cost Clarity, a model that bases costs on independent cost baselines, such as NADAC and wholesale costs.
- Cost Advantage, a flexible, pass-through model using average ingredient costs and reflecting real-time network price improvements.
Optum Infusion Pharmacy
Optum Infusion Pharmacy provides safe and effective infusion care, at home or in an infusion suite, for patients with acute and chronic conditions.
- 24-hour access to registered pharmacists, nurses and dietitians; advocacy services that help patients access medications at a reduced cost; specific patient education programs; and site-of-care options that offer flexibility.
- Provides nationwide infusion nursing support.
- Saves payers up to 50% when home infusion is chosen over a hospital outpatient setting. In addition, 95% of patients report better understanding of their condition.
Optum Home Delivery Pharmacy
Optum Home Delivery is a safe, convenient and cost-effective alternative to a retail pharmacy for consumers to receive their medications.
- Medication adherence of more than 20% over retail pharmacies.
- ~520K prescriptions are delivered to consumer homes daily.
- Saves members on average $10 to $12 per medication.
Optum Frontier Therapies
Optum Frontier Therapies is a health care services business specializing in providing access to gene and rare disease therapies and developing tailored clinical support and services for patients.
- We partner with stakeholders to provide customizable pharmacy and patient services, distribute and dispense specialty medications and utilize data to improve outcomes.
- We offer end-to-end patient support with ultra-specialized distribution to all 50 states.
Optum Specialty Pharmacy
Optum Specialty Pharmacy offers a hands-on approach to patient care for people that require specialty treatments. You can count on our guidance, education, and compassion throughout a patient’s entire treatment journey, including:
- Secure delivery: Delivery to your home or address of your choosing at no cost to you.
- 24/7 clinical support: Expert clinicians available 24/7 to answer questions and provide support, including secure video chats where you can receive training or ask questions from the privacy of your home.
- Digital support: We support adherence and health equity through programs like Schedule My Fill and Optum Savings IQ that proactively provide refill reminders and help patients overcome the cost hurdle. We provided more than $900M in overall patient financial assistance in 2022.
Optum Rx is helping people access the medications they need at prices they can afford.