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Optum Rx pharmacy benefit management

Making pharmacy benefits clear

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

We’re setting the industry standard in transparency

Plan sponsors

Providing you end-to-end transparency from formulary guidance and choice, audit rights, and pricing options that align with your plan.

Providers

Equipping providers with the tools to get insights to your plan and get members on the right medication and insights to your plan is critical to ensure plan support.

Members

Driving access and advocating for members through transparent, lowest-available price and guidance on prior authorizations.

End-to-end transparency at every step

Optum Rx provides end-to-end transparent, clear and verifiable information and service to plan sponsors, providers and members, including:

  • Clinical-first drug evaluation through an open, independent pharmacy and therapeutics committee (P&T).
  • Formulary choices with expert clinical guidance.
  • Audit rights that provide verifiable confidence your plan is administered as promised.
  • Pricing models that deliver transparent, 100% rebate pass-through.
  • Pricing guardrails to ensure balanced pricing and remove pricing volatility.
  • Tools for providers to ensure patient access.
  • Consumer advocacy and protection that guide to the best care at the lowest price.

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Avoid surprises in pharmacy spend

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Empowering clients with choice and transparency

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Case study

Advanced Pharmacy Audit Services

See how a health plan used advanced audit services to prevent and detect pharmacy fraud, saving over $1 million.

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Redefining the prior authorization process

Learn how we are revamping the prescribing process.

Learn more about what it means to have a transparent pharmacy benefit manager