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OptumRx Inc.

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Latest From OptumRx Inc.

Payer Transparency Reforms: Moving From Rebates To Drug Access Restrictions

Institute for Clinical and Economic Review analysis of whether payers are providing ‘fair access’ to fairly priced drugs was hampered by a lack of transparency among payers, leading to calls for reform.

Reimbursement Pricing Strategies

PBM Formulary Exclusions In Oncology Are On The Rise

Oncology drugs are no longer immune to pharmacy benefit management formulary exclusions in the commercial market and even drugs administered in a physician’s office are increasingly being subjected to rebate-driven coverage decisions.

Reimbursement Pricing Strategies

ICER Will Explore Link Between Reasonable Drug Pricing And ‘Fair’ US Formulary Policies

Study will examine prior authorization and other access restrictions at 15 of the largest US commercial payers for a group of 27 drugs.

Commercial Market Access

ICER Study On Coverage 'Fairness' Could Inform Manufacturer Pricing vs Benefit Design Debate

Study will look at prior authorization, step therapy and required medication switching for drugs considered to be reasonably priced.

Reimbursement Pricing Debate
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