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Solution suite

Specialty Pharma Solutions

Help clients manage specialty medical drug expenses.

Specialty Guidance Program

The Optum® Specialty Guidance Program (SGP) helps clients control specialty drug costs. It also gives providers evidence-based, payer-compliant clinical guidance to manage complex conditions effectively.

Specialty Guidance Program includes1:

  • Online prior authorization portal and guideline library
  • Digitized clinical policies for over 50 specialty conditions
  • Ability to support all specialty drugs

Proven outcomes in specialty pharma

With over 14 million data points collected and more than 1 million data points for clinical guidance1, our proven outcomes include:

  • Average provider Net Promoter Score®: 621
  • 75% of requests entered by provider through SGP website1
  • Over 91% preferred product adoption1
  • Over 80% site of care adoption1

We focus on specialty non-cancer conditions while the Cancer Guidance Program (CGP) focuses on cancer conditions.

Quick facts

 Over 29 million lives have been managed through our program.1

Rising global spend

The projected specialty medicine spend by 20232 is $505 billion.

High cost

The average cost of a specialty drug will be $84,000–$136,000 in 2023.3

Increasing number of specialty drugs

The per member annual specialty spend is projected to reach $1,276 in 2023.4

Additional insight

Medical knowledge doubles every 73 days.4

What is the Specialty Guidance Program?

There’s an easy way for providers to stay up to date on specialty drugs and make sure that everything goes smoothly for you and your members. Learn how our program works in this video.

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Product information and resources

  • PDF

     

    White paper

    About Specialty Guidance Program

    Learn what’s new with the Specialty Guidance Program.

    Download
  • PDF

     

    White paper

    Specialty drug market: Alzheimer’s disease

    We're keeping up with the ever-changing specialty drug market.

    Download
  • PDF

     

    White paper

    The looming biosimilars boom

    Learn 5 things payers need to know about the looming biosimilars boom.

    Download

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Complementary solutions

Specialty Fusion

Experience a specialty drug management solution that does more by bringing medical and pharmacy benefits together at the point of care.

Specialty Management

Simplify specialty care with medical and pharmacy solutions that deliver enhanced analytics to inform strategy and lower costs.
  1. Optum book of business proprietary analysis. Results will vary by client.
  2. EvaluatePharma. Orphan Drug Report 2019. April 25, 2019. Accessed January 2023.
  3. PR Newswire. Global $568 billion specialty pharmaceuticals market to 2026: leverage the changing face of specialty pharmacy industry with flat world solutions. September 10, 2019. Accessed January 2023.