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 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 the National Average Drug Acquisition Cost (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 treatment for patients who require infusion therapy to treat their complex conditions.
- 24-hour access to registered pharmacists, nurses and dieticians; advocacy services that help patients access medications at a reduced cost; specific patient education programs; and site-of-care options that offer flexibility.
- Conducts 335,000 nurse infusion visits annually.
- Saves payers up to 50% when home infusion is chosen over a hospital outpatient setting.
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 adjusted prescriptions are delivered to consumer homes daily.
- Saves members on average $10 to $12 per medication.
Optum Frontier Therapies
A specialty pharmacy and distribution business serving people with rare diseases.
- We partner with stakeholders to provide customizable pharmacy and patient services, distribute and dispense specialty medications and utilize data to improve outcomes.
- Approximately 200 limited distribution drug contracts.