Optum Rx launches Price Edge to offer lower prices on generics
If there is a lower cost to the member outside of their insurance benefit, Price Edge automatically applies that price, company says.
Photo: Shana Novak/Getty Images
Optum Rx, UnitedHealth Group's pharmacy services company, has launched Price Edge, a tool that compares available direct-to-consumer pricing for traditional generic drugs with insurance pricing. The goal is to ensure members get the lowest prescription drug price.
Price Edge is being offered to all Optum Rx clients, the company said this week.
Optum Rx positioned the tool as an enhancement of the company's ability to offer a lower price on generics at about a 90% rate. Price Edge, the company said, ensures competitive consumer prices on generics by scanning available prices and automatically providing the lowest available pricing to the member.
If there is a lower cost to the member outside of their insurance benefit, Price Edge automatically applies that price, Optum said.
WHAT'S THE IMPACT
Transactions initiated through Price Edge count toward the member's deductible and out-of-pocket maximum, which Optum Rx said differentiates the tool from other direct-to-consumer pharmacy solutions or cash market pricing.
Plan sponsors also do not incur additional administrative fees for implementing Price Edge, and their members automatically access the tool within their plan at no cost. By capturing all transactions within the member benefit, the company said Price Edge maintains continuity of safety protocols and safeguards against contraindications between medications.
It's the latest in a suite of products and tools designed to improve the pharmacy experience for consumers and healthcare professionals. For example, PreCheck MyScript -- another Optum product -- offers providers real-time information on a patient's pharmacy benefits and formulary to help identify the right drug to prescribe, obtain any prior authorizations and see the drug costs.
Solutions including MyScript Finder and Proactive Savings Alerts allow consumers, clients and providers to obtain information to make informed decisions about their care – including real-time prior authorization, point-of-sale rebates, and notifications on savings opportunities, said Optum Rx.
THE LARGER TREND
Optum and Change Healthcare officially merged in October but the Department of Justice appealed that decision in November. The estimated $13 billion merger combined UnitedHealth Group, the parent company of the nation's largest health insurer, and Change Healthcare, among the nation's largest electronic data interchange clearinghouses.
The DOJ attempted to block the merger before it went through. A court decision on September 19 ruled in favor of Optum and Change. The basis of the DOJ's case centered on the competitively sensitive data UnitedHealth would gain from its rivals through the acquisition uniting UHG subsidiary Optum Insight and Change. The American Hospital Association raised antitrust concerns.
Twitter: @JELagasse
Email the writer: Jeff.Lagasse@himssmedia.com
