Utilization Management Optimization

UTILIZATION MANAGEMENT OPTIMIZATION

Kelly Dubuc, OptumRx Senior Product Manager

Pharmacy spend is expected to grow at a steady 2-5% through 2025. Some specialty therapeutic classes are expected to grow at a much higher rate of 9-12%.

The OptumRx Utilization Management (UM) Optimization program enhances our UM strategy by verifying appropriate drug use via documentation from the provider team, and addresses concerns associated with high-cost medications through increased oversight by a pharmacist. It results in significant client savings in key drug categories and drives increased use of lower-cost alternatives while ensuring consumers are using the most clinically appropriate medication.  In addition, consumers may also save on their out-of-pocket costs due to the use of lower-cost alternatives.

In this webinar you will learn how the OptumRx Utilization Management Optimization program works to help manage pharmacy spend through the use of an enhanced Prior Authorization program.

Takeaways Include:

• Learn how the OptumRx Utilization Management (UM) Optimization program enhances our UM strategy, driving significant client savings while ensuring appropriate medication use.
• Understand the requirements for implementing the UM Optimization program and the potential impact to drug spend and member experience.

For Health Action Council OptumRx user group members only.