Open Book: Delivering transparent pharmacy benefits

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[On-screen text – Optum Rx]

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[On-screen text – The first comprehensive, transparent pharmacy benefit manager]

[MALE NARRATOR] Optum Rx® is proud to be the first comprehensive, transparent pharmacy benefit manager.

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[On-screen text – But what is transparency?]

But what is transparency?

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Some equate transparency with just having visibility into what prescription drugs cost.

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[On-screen text – We go much further]

We go much further, to promote transparency by giving you access to a wide variety of information well beyond drug pricing,

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[On-screen text – How drugs are evaluated + How formulary decisions are made]

including how drugs are evaluated and how formulary decisions are made.

[Graphic, a magnifying glass over the words: “How we deliver transparency”]

[On-screen text – How we deliver transparency]

With Optum Rx®, you can expect simplified access to data

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[On-screen text – Contracting language, Fee structures, Pharmacy network changes]

such as contracting language, fee structures, and pharmacy network changes, the ability to drill down into data about individual drugs

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[On-screen text – Utilization factors]

and the factors impacting their utilization,

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[On-screen text – Auditing data]

and access to multiple types of data for auditing purposes.

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[On-screen text – Tools and expertise]

We'll also furnish you with the tools and expertise to better interpret and make decisions grounded in data.

[Graphic, a magnifying glass over the words: “Transparent clinical decision”]

[On-screen text – Transparent clinical decisions]

Take, for example, clinical decisions.

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One of the most important things for a plan sponsor to know is which drugs their members are taking.

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[On-screen text – Independent Pharmacy and Therapeutics Committee (P&T)

As new drugs enter the market, they undergo a rigorous evidence-based review from our Independent Pharmacy and Therapeutics Committee, P&T.

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Comprised of independent physicians, pharmacists, and clinicians,

[On-screen text – Relevant data + Scientific literature]

the P&T committee meets regularly to consider the relevant data and scientific literature for new and existing medications and their potential place in therapy.

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[On-screen text – P&T materials]

Optum Rx® clients are welcome to review P&T materials to get an inside look at our clinical deliberations.

[Graphic, a magnifying glass over the words: “Transparent formulary construction”]

[On-screen text – Transparent formulary construction]

Transparency is also vital to understanding how formularies are constructed.

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Just because a drug is clinically appropriate doesn't necessarily mean it's right for your plan.

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 [On-screen text – Clinical consultants + Formulary strategy advisors]

This is where our clinical consultants and formulary strategy advisors come in.

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They will meet with you to review clinical recommendations and cost modeling to help you decide which medications best meet your unique needs.

[Graphic, a magnifying glass over the words: “Transparent pricing”]

[On-screen text – Transparent pricing]

Transparency is also paramount when deciding how you will pay for these medications.

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[On-screen text – Cost Made Clear, Several different payment options]

Our Costs Made Clear transparent pricing models offer several different payment options, each designed with transparency in mind.

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[On-screen text – 100% pass-through models, Cost-plus models, Reference-based models]

These include 100% pass-through models, cost-plus models, and reference-based model options,

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[On-screen text – What we pay, What you pay, How you pay]

each of which clearly shows what we pay, what you pay, and how.

[Graphic, a magnifying glass over the words: “Visibility for providers and members”]

[On-screen text – Visibility for providers and members]

Yet plant sponsors are not the only stakeholders that benefit from transparency.

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[On-screen text – Access to information]

Members and care providers also need access to information to make better informed decisions.

[Animation, arrows between three graphics: prescription medication bottles, a checkmark, and a prescription medication box]

[On-screen text – PreCheck MyScript®]

Our real-time benefit check tool, PreCheck MyScript®, is embedded into a physician's existing prescribing workflow.

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PreCheck MyScript® enables doctors to check current prescription coverage and price based on the member's benefit plan and find possible medication alternatives when appropriate.

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[On-screen text – Real-time pricing data]

Access to real-time pricing data also empowers members.

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[On-screen text – Price Edge comparison tool, Direct-to-consumer, Insurance]

Our Price Edge comparison tool compares direct-to-consumer prices with insurance pricing

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[On-screen text – Lowest available prescription drug price]

to ensure members always get the lowest available prescription drug price, covered or not.

[Graphic, a magnifying glass over the words: “A comprehensive approach”]

[On-screen text – A comprehensive approach]

Given the complexity of pharmacy benefits, we know a single tool or process cannot provide sufficient transparency.

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That's why we will continue to advance our market-leading suite of transparency capabilities to deliver greater insight and accountability for you.

 [On-screen text – Optum Rx®, Visit optum.com/clear]

Contact your Optum Rx® partner for more about our comprehensive approach to transparency.