Designs made together, with clarity
As the first comprehensive, transparent pharmacy benefits provider, we don’t just make decisions — we show you how they’re made and why they were made. Decisions are explainable, reviewable and grounded in clinical integrity and economic clarity.
Transparency designed for everyone
We take the guesswork out of pharmacy benefits — for everyone we serve.
Clear drug costs, no surprises
Real-time drug costs, savings and alternatives up front mean:
- Fewer disruptions
- Faster access
- Better experiences
This looks like $194 savings for every prescription switched in the doctor’s office using PreCheck MyScript® and more than $90 average savings online with MyScript Finder®.1
We show our work
Formulary, pricing and utilization decisions are reviewable and backed by clear rationale. You can see it in outcomes:
- 100% visibility on net cost
- $0 margin on drugs with pass-through pricing
- Open and independent Pharmacy and Therapeutics Committee
Clarity at the point of care
With PreCheck MyScript, doctors see net cost, coverage and alternatives before prescribing for better informed decisions.
And our industry-first innovation, PreCheck Prior Authorization, provides prior authorization approval decisions in under 30 seconds.2
Pharmacy benefits transparency FAQ
At Optum Rx, open book transparency means you can see how:
- Decisions are made
- Dollars flow
- Results are measured and verified
Our transparency commitment is built around 4 key areas:
- Clinical transparency
- Pricing and economic visibility
- Controls and audit privileges
- Member and provider tools that make transparency real at the point of care
Optum Rx is different because we operate as a transparent pharmacy benefits provider by design, not by exception. At the point of care, we combine:
- Open financial models
- Independent clinical oversight
- Real-time decision transparency
That means economics aren’t hidden in complexity — they’re visible, auditable and aligned to client and member outcomes.
We provide visibility into net cost by aligning our financial models to transparency and by connecting the clinical decision to the economics behind it. With Open Book pricing and passthrough options, clients can see actual net drug costs, not just estimates or reconciliations later.
With our pharmacy care model, clients will be offered a pricing structure with monthly, clearly defined fees per member that are independent of manufacturers’ list prices or prescription volume, eliminating spread pricing and similar practices. By the end of 2027, group purchasing will fully transition to flat service fees.
Clinical decisions start with our open, independent Pharmacy & Therapeutics (P&T) Committee, made up of independent practicing physicians and pharmacists as well as a patient representative.
The P&T Committee evaluates medications based on clinical evidence, safety and effectiveness, not cost. For added transparency, clients are welcome to observe the P&T process.
For providers, transparency means clarity before prescribing. We embed point-of-care tools into the doctor’s workflow. With PreCheck MyScript®, doctors see their patient’s benefit plan, including net cost, coverage and clinically appropriate alternatives in real time. This enables better-informed prescribing decisions and reduces downstream disruptions for patients.
PreCheck Prior Authorization further cuts the administrative burden with approval times under 30 seconds and a 68% reduction in denials due to missing information.2
Transparency improves the member experience by removing surprises. Members see:
- Real-time costs
- Savings opportunities
- Alternatives upfront
This leads to fewer disruptions, faster access and better pharmacy benefit experiences.
For example, Price Edge automatically compares direct-to-consumer pharmacy prices with insurance pricing to help members access the lowest available cost for eligible generic drugs. In 2025, members saved $273M automatically with Price Edge.1
With PreCheck MyScript®, clients save $343 per switch, and members save $194. With MyScript FinderTM, members save over $90 on average per switch.1
Transparency enables action. By making costs and alternatives visible at every decision point, Optum Rx helps clients and members make lower-cost choices.
At Optum Rx, transparency is an operating model. It’s embedded in how we design benefits, manage trend, support providers and guide member decisions. Open Book isn’t a report you review later; it’s how pharmacy benefits are managed end to end.
Transparency matters because it builds confidence and trust — but only when it creates clarity. Optum Rx goes beyond disclosure to deliver decision-level transparency that:
- Removes economic ambiguity
- Supports better choices
- Helps clients confidently manage pharmacy spend in a volatile market
Industry insights
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Discover our latest innovation to the PA process — PreCheck Prior Authorization — which reduces approval times, appeals and denials.
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At Optum Rx, we’re using AI responsibly — fairly, safely, ethically — to make health care easier and better for the people we serve.
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Hear how PBMs negotiate to deliver the lowest possible cost, benefiting plan sponsors and members alike.
- 2025 internal analysis.
- Optum Rx and Surescripts data. April–June 2024.