Skip to main content

Pharmacy benefit management

Controlling specialty drug costs

We take an integrated approach to specialty drug management by managing across both benefits and creating a seamless patient experience.

Smoothing cost variations on the medical side

Optum MedicalRx Specialty Provider Network helps plan sponsors control the cost of specialty drugs by standardizing fair market-value reimbursement rates for providers within the network. The solution saves plan sponsors $1.38 per member per month.1

Piggy bank savings still shot

Key benefits

We deliberately align cost management strategies to deliver healthier outcomes and savings opportunities. 

$16 PMPM plan savings

What plan sponsors save with Optum specialty management.2 

$1.7B highly managed plan savings

What plans saved with Optum Specialty Pharmacy.3

$823.5M patient financial assistance

Financial assistance we delivered in 2023.4

What you can expect from Optum Specialty Pharmacy

This is foundational to any specialty strategy, and it’s what makes our cross-benefit approach so powerful. Helping plan sponsors manage utilization, avoid waste and take full advantage of market trends, that’s just the start of your savings opportunities.

The people we serve are at the center of specialty medication management. Leveraging our analytics, technology, and clinical resources, we personalize care, collaborate with providers and help ease access for members.

Sometimes the most effective drug management is on the medical benefit. Aligning medical and pharmacy specialty management so closely has led to $16 PMPM savings on specialty drug spend and MedicalRx Rebates alone has reduced costs by $7.80 - $8.40 PMPM.

Optum has the pharmacy and medical footprint, data and expertise to help plan sponsors and providers make more precise specialty decisions based on whichever benefit offers the greatest clinical and cost advantage.

Innovative pharmacy solutions

Improving medication affordability

Providing you with solutions that make it easier to lower drug spend.

Driving pharmacy innovations

You need simple, intelligent and adaptive solutions for your pharmacy benefit plan – fueled by the power of Optum.

Leading the industry in transparency

We deliver accessible and clear pharmacy benefit information, transparent drug pricing, and a simplified experience for everyone we serve.

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.

Pharmacy benefit management

Manage pharmacy spend across a health system and explore hospice solutions.

Related healthcare insights

E-book

Get immediate savings on specialty drugs

Specialty drug spend is a “top threat” to employer-provided benefits. Discover sustainable savings with your existing Optum Rx plan.

Article

Avoid surprises in pharmacy spend

Old strategies and new challenges don’t mix. Future-proof your plan and get better predictability with new pricing models and risk management tools.

E-book

Slash medication costs three steps

This is your employer guide to reducing your healthcare spending.

  1. Optum internal analysis based on 18.5 million commercial lives from Jan. 1, 2019 to Sept. 3, 2020.
  2. Specialty savings book of business April 2021 on a standalone basis, not tied to the medical carrier.
  3. Clinical interventions: Optum Patient Exchange Intervention Tool, Book of Business, 8/1/20-7/31/21, Generic conversion: Optum Specialty Pharmacy BOB Data 7/1/2021 – 8/24/2022.
  4. Optum Specialty Pharmacy Patient Assistance Active Grant Report and Optum copay card assistance totals report, 2023.