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Pharmacy benefit solutions built for you

At Optum Rx, we’re built differently. We offer clear pricing, aligned scale and insights that guide decision-making, helping you move forward with confidence.

How Optum Rx pharmacy benefits better serve you

You need — and expect — pharmacy benefit solutions built around your priorities and supported by clarity, guidance and control.​ At Optum Rx®, that’s exactly what we do. With us, you can expect:​

  • An Open Book approach  decisions you can see and trust from the start.
  • Aligned scale  buying power and technology investment that work for you.
  • Action backed by data and insight — with advanced analytics, artificial intelligence (AI) and expert support.​

Together, these commitments create a partnership that doesn’t just perform — it adapts, explains and leads through what’s next.

Learn more about our approach

Smarter benefits with AI and advanced tech

As the leader in advanced technology and the responsible use of AI, we’re supercharging the pharmacy benefit experience and driving meaningful results.

Guiding and designing your pharmacy benefit solutions

You shouldn’t have to choose between what’s best for your employees and your bottom line. We partner with you using data and intelligent technology, clinical expertise and deep industry experience to help guide and design your pharmacy benefits to meet your needs. 

Solution suite

Aligned to scale with your pharmacy benefit needs

Best for:
  • Brokers and consultants
  • Employers
  • Health systems and hospitals
  • Payers
  • State governments

Our pharmacy benefit solutions are aligned to your priorities, not the other way around. We work towards them, together.

Solution suite

Controlling specialty drug costs

Best for:
  • Brokers and consultants
  • Employers
  • Health systems and hospitals
  • Payers
  • State governments

The cost and complexity of specialty drugs requires a solution that provides care without compromise. The outcome is a better experience and lower costs.

Solution suite

Smarter Pharmacy Benefits with AI

Best for:
  • Brokers and consultants
  • Employers
  • Health systems and hospitals
  • Payers
  • State governments

We’re using responsible artificial intelligence (AI) capabilities to supercharge pharmacy benefit experiences and drive meaningful results.

Solution suite

Open Book: Delivering transparent pharmacy benefits

Best for:
  • Brokers and consultants
  • Employers
  • Health systems and hospitals
  • Payers
  • State governments

Transparency is how we operate on a daily basis, from independent clinical decisions to pass-through economics and real-time clarity at the point of care.

Solution suite

Pharmacy Benefit Management for Health Plans

Best for:
  • Payers

We help health plans customize networks, plan designs and formulary options, redefining quality with our expertise and claims processing technology.

Solution suite

Pharmacy benefits backed by data and insight

Best for:
  • Brokers and consultants
  • Employers
  • Health systems and hospitals
  • Payers
  • State governments

We help members, providers and clients act with clarity and confidence — earlier and faster.

Solution suite

Pharmacy Solutions for Workers' Comp and Auto No-Fault

Best for:
  • Employers
  • Health systems and hospitals
  • Payers

We expertly handle the nuances of workers' comp and auto claims to lower costs, apply our unique clinical expertise, and provide a better experience for you, your staff, and the claimants you support.

Solution suite

What happens when pharmacy benefits are built differently

Best for:
  • Brokers and consultants
  • Employers
  • Health systems and hospitals
  • Payers
  • State governments

We're transforming pharmacy benefits to deliver real clarity, real savings and real results.​

Delivering better value for our plan sponsors

You know your members best — and we’re here to help you support them. Together, we’ll find the right solutions to ease rising drug costs and improve health outcomes. And we'll tailor them to your plan’s unique pharmacy needs.

Better plan value on blue background

What's a pharmacy benefit manager?

Pharmacy benefit managers (or PBMs) serve plan sponsors by offering prescription medication benefits to their members. As a PBM, Optum Rx acts as a liaison between plan sponsors and manufacturers, pharmacies and health insurance companies. We negotiate drug prices and rebates, helping to lower the cost of prescription drugs. 

PMBs also offer value-added services, such as:

  • Plan strategy, clinical expertise and regulatory advocacy
  • Cost-management solutions to reduce drug spend
  • Disease management support

Our goal: superior clinical outcomes, made easier.

Pharmacy benefit management FAQ

Essential PBM services include:

At Optum Rx, Built for You means our pharmacy benefit solutions are designed around your priorities, not a one-size-fits-all model. We align transparency, scale and advanced analytics to your goals so you can navigate change with clarity, confidence and control, today and in the future.

Optum Rx is built on 3 structural advantages that work together:

  1. Transparency
  2. Scale aligned to client outcomes
  3. Insight translated into action

Rather than asking clients to adapt to our model, we design our capabilities, economics and technology to flex with changing needs and market conditions.

Our transparency commitment gives clients, partners and plan sponsors visibility into how:

  • Clinical decisions are made
  • Dollars flow
  • How performance is measured and verified

We back this commitment with independent clinical governance, audit‑ready access and data that allows clients to validate outcomes and pricing.

Our pharmacy care model fundamentally changes how pharmacy benefits are priced and delivered — replacing traditional approaches tied to drug prices set by manufacturers or prescription volume with a transparent, fee‑based structure.

Scale alone isn’t the advantage. How it’s applied is. Optum Rx directs buying power, technology investment and clinical expertise intentionally to lower costs, simplify operations and improve experiences for clients and members, rather than extracting value through complexity. Start aligning our scale with your pharmacy benefit needs today.

We embed intelligence directly into workflows so insight leads to action at the moments that matter. Advanced analytics, AI and expert support help:

  • Surface risks sooner
  • Guide decisions in real time and reduce surprises
  • Enable our clients to act with confidence in what comes next

Clients experience measurable impact through:

  • End-to-end visibility on net cost
  • 19% PMPM savings1 when aligned strategies are deployed
  • $90+ average member savings with MyScript FinderTM, 1 
  • Faster administrative decisions with prior authorization approvals under 30 seconds.2

These outcomes reflect how transparency, scale and action work together, not in isolation.

Automation and embedded intelligence remove unnecessary barriers. From faster prior authorization decisions to automated savings at the pharmacy counter, Optum Rx simplifies processes, so clients, providers and members spend less time navigating friction and more time focusing on care.

AI at Optum Rx is used to enhance — not replace — human expertise. We’re laying the groundwork for better pharmacy benefits by:

  • Investing $1.5B in AI-related developments
  • Deploying more than 1,000 AI solutions
  • Certifying over 17,000 AI engineers

Advanced models help detect fraud, anticipate member needs, improve clinical review and streamline communication, with clinicians and service teams always in the loop to ensure accuracy, transparency and trust.

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  1. Optum Rx analysis. 2025.
  2. Optum Rx and Surescripts data. April - June 2024.