OptumRx has launched initiatives designed to expand services available at community and rural pharmacies amid impending legislation that would squeeze benefits managers’ business practices. Pharmacies.
PBM, owned by UnitedHealth Group, will work with pharmacies in seven states to connect pregnant women and diabetes patients with assistance with housing, transportation and food, Ty said on Tuesday. OptumRx will rely on community pharmacists to connect members with Unite Us, a software company that will link members in Louisiana, Nebraska, New Jersey, New Mexico, New York, North Carolina, and Texas with affiliates. local resources starting in June. The plan calls for a nationwide expansion of the program in the fall.
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OptumRx said it will launch a separate program to advertise preventive care services to pregnant women by local pharmacies starting in July, followed by a program to connect living individuals. in areas lacking interest in health care services at community pharmacies in the fall.
The company’s announcement follows an announcement by Express Scripts last month, which promoted a “transparent” transitional payment plan for employers and said it was raising wages for pharmacies. rural independence.
In a press release, OptumRx said the initiatives aim to close the health disparity gap for patients living in rural or desert healthcare areas. The company did not disclose how many pharmacies it expects to work with, the number of members it hopes to serve, or its financial investment.
OptumRx declined to provide an executive for an interview.
The programs follow OptumRx initiatives to increase drug pricing transparency for customers and as lawmakers debate a number of reforms in the PBM industry.
A House committee last week introduced a bill that would require PBMs to provide detailed information to employers about the prices paid for drugs, among other provisions. Additionally, a Senate committee earlier this month voted to pass a bill that would ban PBMs from using arbitrage and force companies to pass all rebates received from drug manufacturers, Both of these items are blamed by lawmakers for contributing to rising drug costs. Arbitrage pricing occurs when PBMs charge payers more than they reimburse the pharmacy for a drug and withhold the difference.
Last week, the Federal Trade Commission expanded its investigation into OptumRx and other PBM businesses to include group buying organizations, which negotiate discounts on behalf of PBMs.
The three largest PBMs are linked to insurance companies after years of industry consolidation. OptumRx is the third-largest PBM by market share, responsible for handling 22% of prescription requests by 2022, according to data from Drug Channels, a research firm. CVS Health Caremark controls 33% of the market while Cigna’s Express Scripts holds 24% of the market.
Lobbying group PBM The Pharmaceutical Care Management Association launched a seven-figure ad campaign Tuesday blaming drugmakers for increasing prescription drug prices. Insurance lobby group AHIP launched a similar seven-figure advertising campaign last month blaming drugmakers for high drug costs.
