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
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About Specialty Guidance Program
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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.
- Optum book of business proprietary analysis. Results will vary by client.
- EvaluatePharma. Orphan Drug Report 2019. April 25, 2019. Accessed January 2023.
- 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.