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Optum Rx pharmacy benefit management

Simplifying the pharmacy benefit experience

We focus on delivering transparent, affordable, simplified pharmacy benefits for plan sponsors and the members we serve.

A seamless PBM experience

We're committed to creating a more connected pharmacy benefit management (PBM) experience through access, affordability and advocacy – for you, your members and the providers who care for them.

Navigating the health system with ease

Introducing Benefit Central

Industry-leading benefit management capabilities

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

Screenshots of the new Optum Rx Client Portal, Benefit Central

With expert support

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

A couple hiking through a field with backpacks on and mountains in the background

Award-winning communication plan

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.

Woman in her kitchen leaning on a counter looking at a tablet

Transforming the experience with PreCheck

Automation streamlines the process and eases administration

Our industry-first innovation, PreCheck Prior Authorization expedites prior authorizations, decreasing turnaround times to under 30 seconds.2 With PreCheck MyScript, members can save an average of $119, and clients save $237 per switched medication.3

Female doctor wearing glasses and a stethoscope looking at a tablet

MyScript Finder shares real-time cost savings

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

Smiling mother in a swimming pool with her daughter in a yellow floatie

Taking the paper out of member communications

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

How do we support members?

We guide members every step of the way, making it easy for them to get the medications they need at the prices they can afford.

Expedited prior authorization approvals

PreCheck Prior Authorization, an industry-first innovation, reduces the turnaround time to under 30 seconds6

Member savings in the doctor’s office

PreCheck MyScript gives doctors real-time, plan-specific medication details at the point of prescribing, saving members $119 on average7.

Member savings online and on-the-go

Proactive Savings Alerts identify savings opportunities and alert members directly, saving them $24 on average per 30-day script8.

First call resolution

97% of member calls are resolved on their first call9.

Related healthcare insights

Article

Automating the prior authorization process

Discover our latest innovation to the PA process — PreCheck Prior Authorization — which reduces approval times, appeals and denials.

Article

How to manage medication overload

Hear from a leader's perspective on how to manage polypharmacy.

Case study

A seamless pharmacy benefit change?

We guarantee it. And it's easier than you think.

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 and Surescripts data. April - June 2024.
  7. Internal analysis. 2023.
  8. Program results. 2023.
  9. Year to date through June 2024 results.