4 keys to specialty medication management

There are all kinds of reasons that specialty medications account for just 2% of prescriptions but 53% of annual pharmacy spend.¹ So how do you narrow that gap while still ensuring medication access for the people you serve? Where do you start?

You make sure that every strategy you apply, every initiative you launch, every solution you implement heeds the 4 keys to effective specialty management. That’s Optum Specialty Medication Management.

  1. IQVIA Institute. The Use of Medicines in the U.S. Published May 27, 2021. Accessed Sept. 29, 2021.
  2. Optum Specialty Pharmacy. Internal analysis of split fill program. 2020.
  3. Optum. Modeling and analysis based on Optum Rx internal book of business data. 2022.
  4. 95% stat for Optum Connections video series. Optum internal data. Based on ongoing patient surveys. 2021.
  5. $133.4 million in foundation-based patient financial assistance Optum Specialty Pharmacy. Patient Assistance Active Grant Report. January 2023.
  6. 785.9 million in copay card assistance Optum. Copay card assistance totals report. January 2023.
  7. 94% improved/maintained adherence Optum. Internal analysis. April 2023.
  8. Reduce costs by $0.39–$1.26 PMPM for specialty redirection Optum internal analysis. Savings are estimates and may vary by client. 2021.
  9. Reduce costs by $7.80–$8.40 PMPM for MedicalRx Rebates Optum commercial claims data. January to June 2020.
  10. Reduce costs by up to $3.28 PMPM for Medical Benefit Optimization Optum internal analysis of 20 million lives. 2020.
  11. Reduce costs by up to $1.38 PMPM for Medical Rx Specialty Provider Network Optum internal analysis based on 18.5 million commercial lives from Jan. 1, 2019 to Sept. 3, 2020.
  12. $15 PMPM savings with specialty fusion Optum internal analysis. Actual savings potential will vary based on plan sponsors who have low to highly managed programs in place. March 2022.