Pharmacy Benefit Management (PBM)

Why choose Optum Rx pharmacy benefits?

We’re transforming pharmacy benefit management — creating transparent, simplified and more affordable access to medications, whether you need care, provide care, or pay for care. Our team of over 200,000 dedicated people are committed to reimagining healthcare, ensuring you receive the best possible service and support. Together, we can achieve better health outcomes and build a transparent, sustainable plan — ensuring medications are accessible and affordable, for everyone. That’s the power of partnership with Optum Rx.

What is a pharmacy benefit manager?

PBMs, like Optum Rx, play a crucial role in the health care system and serve plan sponsors by offering prescription drug benefits to their members. We act as intermediaries between plan sponsors and pharmaceutical manufacturers, pharmacies and health insurance plan companies. We negotiate drug prices and rebates, helping to lower the cost of prescription drugs for plan sponsors and their members.

Pharmacy benefit managers also offer value-added services such as:

Strategic plan guidance, clinical expertise and regulatory advocacy
Optimized cost management solutions to reduce drug spend
Disease management support

The ultimate goal is to deliver superior clinical outcomes through a simplified experience.

What we deliver

We drive value for both you and your members by focusing on three areas.

Transparency

Delivering end-to-end transparent and verifiable information, including provider enablement and consumer protections.

Expertise

Guiding you with clinical expertise and transparent data – backed by the breadth of Optum.

Better Value

Maximizing affordability and access by leveraging our experience, size and scale to solve your challenges.

They live up to the commitments they make and genuinely have the best interest of the plan and members at heart.

Large Employer Group

What you can expect from your PBM

You shouldn’t have to choose between what’s best for your employees and your bottom line. We partner with you using data and intelligent technology, clinical expertise and deep industry experience to help guide and design your pharmacy benefits to meet your needs.

Lowering pharmacy benefit costs

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

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Driving pharmacy innovations

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

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Making pharmacy benefits clear

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

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Controlling specialty drug costs

The cost and complexity of specialty drugs requires a solution that provides care without compromise. The outcome is a better experience and lower costs.

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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.

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Pharmacy Benefit Management for Health Plans

We help health plans customize networks, plan designs and formulary options, redefining quality with our expertise and claims processing technology.

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Hospice pharmacy solutions

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

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Pharmacy Solutions for Workers' Comp and Auto No-Fault

We expertly handle the nuances of workers' comp and auto claims to lower costs, apply our unique clinical expertise, and provide a better experience for you, your staff, and the claimants you support.

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