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Pharmacy benefit management

Redefining the PBM experience

We are creating a simplified, more connected health care experience for you, your members, and the providers who care for them.

Connecting and simplifying the health care system

We are continually innovating – deploying cutting-edge tools and enhancements to make using the health system easier for everyone we serve. Through this, we’re breaking down barriers and redefining the pharmacy benefit management experience.

Navigating the health system with ease

New client implementations

We guarantee a seamless pharmacy benefit change

Plan sponsors have been switching to Optum Rx pharmacy benefit management for more than 25 years because they get value – well beyond a drug’s price. And we guarantee a smooth transition with 100% of client satisfaction guarantees met for 1/1/24.1

Client Central

Industry-leading benefit management capabilities

Client Central offers enhanced onboarding, plan build automation, seamless adjudication and reporting, automated benefit testing, and proactive drug management to optimize pharmacy benefits across your entire population for a streamlined and efficient experience.

Screenshots of the Optum Rx Client Portal, Client Central

Onboarding support

Empowering members to use their pharmacy benefit plan

Our personalized communications start 60 days before go-live and include welcome materials, enrollment support with a pharmacy network directory, covered drug list and drug pricing tool, and transition advocate calls designed to help manage any medication changes.

Prior authorization

Automation streamlines the process and eases administration

More than 80% of prior authorizations are submitted electronically and over 65% are approved in real-time.2 With PreCheck MyScript, members can save an average of $119, and clients save $237 per switched medication.3

Lowest cost medications

Increasing awareness of medication cost and coverage

Members can access MyScript Finder via the online portal or mobile app and get alternative medication suggestions, the lowest cost option prior to the prescription being filled, accurate cost by pharmacy and more. Members who switch their medication save an average of $58.4

Digital-first experience

Fast, frictionless and environmentally-friendly

Consumers expect digital-first experiences for managing their prescriptions. And, while digital promoters have 1.3 more prescriptions per year, they are 1.5 times less likely to cancel a prescription, 8 times less likely to have encountered an issue and have a 3% higher continuity of care.5

Optum Rx’s implementation process was extremely thorough. The team was professional and very good at their job. This was the smoothest transition we have ever gone through.

SVP of Benefits, Large Freight Line Employer Group

Key benefits

Creating connections across the health system simplifies the experience for everyone.

New client implementations

100% of client satisfaction guarantees met for 1/1/24.6

Client Central

100% accuracy in plan build automation since 1/1/23 across more than 850 clients.7

Onboarding support

Clear communication and expert support helped drive a 13% reduction in rejected claims.8

Prior authorization

With PreCheck MyScript, members can save an average of $119, and clients save $237 per switched medication.9

Lowest cost medications

Members who use MyScript Finder and switch their medication save an average of $58.10

Digital first experience

Digital promoters are 1.5 times less likely to cancel a prescription and have a 3% higher continuity of care.11

Headshots of Jason Greenberg, Chief of Operations, and Katie Schumacher, VP of Digital Products

Pharmacy Insights Podcast

Hear from our industry experts on how we’re simplifying the health care experience and breaking down barriers to create a more connected pharmacy experience for you, your members, and the providers who care for them. 

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Connections that count: Redefining the PBM experience

Hear from experts on better ways to simplify the complex health care experience through impactful innovation.

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Taking the paper out of member communications

Discover how digital communications can increase member engagement and lower the cost of care.

Video

Personalized care focusing on the member

Hear from Jon Mahrt, Optum Rx chief of operations, on the role pharmacy plays in our members’ healthcare experience.

Create a simpler, more connected pharmacy benefit plan

Complementary solutions

Caring for pharmacy members

We promise to deliver simple ways for your employees to get the medication they depend on – while advancing health equity for everyone.

Driving appropriate utilization of medications

We are committed to helping members stay adherent to medications while addressing the industry challenges that prevent them from doing so.

Using data to improve health equity

Everyone deserves access to affordable healthcare. Learn how we’re using data and analytics to identify disparities and take steps toward health equity for pharmacy members.
  1. Optum Rx. 1/1/24 commercial client implementation data. 
  2. Optum Rx. Commercial book of business. January–December 2023. 
  3. Ibid.
  4. Optum Rx. Internal analysis. January - September 2023.  
  5. Optum Specialty Pharmacy. Internal data. 2023.
  6. Optum Rx. 1/1/24 commercial client implementation data.  
  7. Optum Rx. Internal data from 1/1/23 to 7/1/24.
  8. Optum Rx. Internal analysis. 2022.  
  9. Optum Rx. Commercial book of business. January–December 2023.
  10. Optum Rx. Internal data. 2023. 
  11. Optum Specialty Pharmacy. Internal data. 2023.