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How we manage prescription drug costs
Prescription drug spending in the United States continues to increase each year. We use several strategies to help manage costs while ensuring members have access to medications they need for the best health outcomes.
Our cost-savings programs include:
Utilization management
• Prior authorization and step therapy • Drug quantity limits
• Opioid management
• Compound management
Network management
Formulary management
• Optum Specialty Pharmacy • Large national network of
retail pharmacies
• 90-day medication at retail options
• Drugs chosen by using clinical data and value
• FDA drug pipeline monitoring
• Vigilant drug program
• Orphan drug program
Biosimilars can help reduce overall costs
New treatments for complex medical conditions are generally very expensive. We are always looking for innovative ways to make specialty drugs more affordable without restricting members’ access.
As part of these efforts, we are closely following the growth of biosimilars in the United States drug market. Biosimilars are less expensive FDA-approved versions of biologic drugs, commonly used for vaccines, allergenics, and cancer treatments.
We continue to proactively monitor the drug pipeline and apply utilization management strategies to provide members with cost- effective access to biosimilars.
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