UnitedHealth Group and its pharmacy benefit manager, OptumRx, are expanding a new program that passes along pharmacy discounts they get from drug manufacturer rebates to all new employer customers.
The program will be for “all new employer-sponsored plans,” taking effect Jan. 1, 2020, UnitedHealth and OptumRx said Tuesday. The effort builds on a program that began Jan. 1 of this year for people enrolled in UnitedHealthcare “fully insured commercial group benefit plans” who now have discounts applied when they fill their prescriptions at the retail pharmacy or through home delivery.
It’s the latest effort by health insurers and pharmacy benefit managers to pass along more prescription drug savings to customers in the face of intense criticism from employers, Congress and the Trump administration. The PBM’s share of rebates, which is the portion of the drug returned by the seller to the buyer, has turned into a nationwide controversy.
Rivals of UnitedHealth Group and OptumRx are also changing their business practices. Last year, for example, CVS Health, which owns the Caremark PBM and the health insurer Aetna, launched a “guaranteed net cost” pricing model that the company says returns 100% of drug rebates to its clients for better “predictability and pricing simplicity,” CVS executives said in December. And other PBMs like Cigna’s Express Scripts subsidiary, have introduced programs with point-of-sale rebates for their clients.
UnitedHealthcare and OptumRx said they “will only support new employer clients that incorporate point-of-sale discounts to consumers as part of their plan design” for new business proposals they receive for 2020. They expect the effort to save employers and health plan customers money, saying the “existing program has already lowered prescription drug costs for consumers by an average of $130 per eligible prescription.”
“Commitments made to support existing clients prior to this date will be grandfathered, including those currently in the sales cycle for January 1, 2020 effective dates,” UnitedHealth’s UnitedHealthcare health insurance business and OptumRx announced Tuesday. “While such plan design has been previously available to all employer customers, this expansion is expected to accelerate adoption of point-of-sale discounts across all types of commercial business, including self-funded.”
Date: March 14, 2019