Optum

4 keys to specialty medication management

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Specialty pharmacy care and clinical expertise

  • Patient management

    Supported by clinical expertise, strong provider relationships, and clinical insights, Optum Specialty Pharmacy focuses on whole-person health.

    Certified clinical experts engage members, using Optum Connections, disease-specific clinical assessments, and clinical interventions to optimize prescriptions, help patients adhere to their treatment, avoid costly complications, and live healthier lives.

    Building on our foundational operations model, we are creating centralized models of care (centers of excellence) to deliver targeted therapeutic expertise for certain high-cost, highly complex specialty conditions.

  • Optum Connections

    This suite of digital tools helps people on specialty medications understand their complex conditions, manage their treatments, and stay adherent. The suite includes:

    • Award-winning virtual visits with pharmacists, clinicians and care coordinators
    • Personalized video series explaining conditions and treatments
    • A nationally accredited patient portal and mobile app
    • Comprehensive texting programs to help promote medication adherence
    • Smart devices that track adherence, provide reminders and allow for real-time clinical interventions

  • Financial assistance

    When onboarding new patients with complex conditions, our patient care coordinators proactively connect patients with available financial resources through Optum Savings IQ™. That way, patients start on therapy faster and stay on therapy longer, leading to higher adherence, better clinical outcomes and cost-savings opportunities.

  • Shipping and refills

    Delivery Choice allows members to have their medication shipped anywhere nationwide — to their home, work, doctor’s office or thousands of UPS access points or FedEx pickup locations.

    Schedule My Fill is our first-to-market, clinically supported patient refill scheduling program that allows patients to proactively schedule their refills for 12 months.

  • Limited-distribution drug access

    We offer a robust medication inventory of limited-distribution drugs and a uniquely connected specialty care continuum.

  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.