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Optum Rx Approach to Affordable Pharmacy Benefits

Optum Rx is comprised of pharmacists, pharmacy technicians, clinicians and health care professionals who work every day to improve health outcomes and simplify the health system for consumers. Our customers – employers, unions, health plans and governments – count on us to help them access the most appropriate medicines at the most affordable cost.

With our pharmacy care model, we are uniquely positioned to address three of the most significant problems in health care:

Increasing drug prices

The median monthly price for a newly launched drug almost tripled between 2011 and 2022.


Cost pressures from high-priced specialty drugs

Specialty drugs account for about 2% of prescriptions and 50% of total drug spend.


A fragmented health care system

Care delivery often involves multiple providers and organizations, with no single entity coordinating the different aspects of a patient’s care. Complexity and poor health care coordination nearly doubles the cost of patient care.



While we are delivering better health outcomes and consumer experiences, our approach to pharmacy care services helps us better manage and lower the price of prescription drugs. Optum Rx plays four essential roles in serving customers and consumers, which include:

  • Developing a drug formulary with a strong clinical foundation.
  • Negotiating with drug manufacturers to drive toward the lowest net cost for medicines.
  • Developing a range of options for our customers to compensate us for providing the prescription drug benefit.
  • Deploying innovative clinical support programs that lead to affordable, high-quality care.

Our integrated pharmacy platform helps people achieve better health and lowers overall costs of care through:

Pharmacy Services

Integrated pharmacy services, which include our home delivery and multidose packaging solutions, specialty and infusion services and our community pharmacies.

Direct-to-Consumer Offerings

Direct-to-consumer offerings, built to provide a range of tailored health products and services, all in one place – simply and affordably, whether a person has traditional benefits or not, to help consumers navigate the health care system.

Pharmacy Benefit Solutions

Our pharmacy benefit solutions drive affordability for clients and consumers through direct negotiations with pharma and pharmacies and improve health outcomes for consumers. While our role in negotiating with pharma is essential to lowering health care costs, our role in helping patients navigate their benefits, and providers caring for patients, are critical focus areas for us. Our pharmacy benefit business provides best-in-class client transparency, clinical policy and analytics.

Our differentiated pharmacy care model is resulting in deeper, more meaningful relationships and trust with clients, consumers and other stakeholders through affordability, transparency and value alignment.