UnitedHealth and OptumRx will significantly expand a program that will require new employer clients to pass rebates to the consumers who take their medications.
The shift will apply to employers that sign new contracts with UnitedHealth's pharmacy benefit manager OptumRx after Jan. 1, 2020. UnitedHealth said existing members would have the choice of adopting this plan during contract renewal.
Drugmakers pay rebates to insurers and PBMs to lower the list price of prescription drugs in exchange for being included on their formularies, a list of approved drugs. Insurers and PBMs often pass these rebates to their employer clients, who may use them to reduce premiums for workers, help cover their costs of offering an employer-sponsored plan or pass them on at the point of sale.
Beginning in 2020, OptumRx and UnitedHealth will only support new employer clients that incorporate these point-of-sale discounts into their health plan design. This builds on an existing point-of-sale discount program that became effective in January.
This marks the latest effort by health insurers and pharmacy benefit managers to pass along more prescription drug savings to customers amid increasing criticism from employers, lawmakers and the Trump administration.