UnitedHealthcare broadens drug rebate program

Modesto Morganelli
Marzo 14, 2019

UnitedHealth Group Inc said on Tuesday that starting next year it will expand its drug discount program to all new employer-sponsored health plans and pass on rebates to consumers.

Pharmaceutical companies and insurers have come under scrutiny by the Trump administration and members of Congress, and have struggled to show that they are doing something to address high drug prices.

Specifically, for new business proposals beginning January 2020, OptumRx and UnitedHealthcare will only support new employer clients that incorporate point-of-sale discounts to consumers as part of their plan design. But those discounts rarely flow directly to the people filling prescriptions. Those are often passed on companies that sponsor employee insurance plans to lower everyone's premiums.

Drugmakers say they are under pressure to provide rebates to the three PBMs that dominate the market in order to have their drugs included on preferred coverage lists, ensuring patients can access them. That's generally small employers.

The health insurer earlier this year began passing the rebates to about 9 million consumers enrolled in health plans, helping them save an average of $130 per eligible prescription.

Drug rebates have become a growing point of contention as the cost of medical care and prescription drugs rises.

UnitedHealthcare said Tuesday that its initial direct-rebate program, begun past year, has lowered drug costs by an average of $130 per prescription.

Health and Human Services Secretary Alex Azar has pushed to turn them more into upfront discounts the customer gets when paying for the drug.

"OptumRx is uniquely able to deploy the broadest range of tools to rein in high drug prices, and this expanded point-of-sale discount program demonstrates our commitment to delivering better prices for consumers", said John Prince, chief executive officer, OptumRx.

Leerink analyst Ana Gupte said in a research note that she expects other health plans to follow UnitedHealth's lead in requiring more rebates to be offered directly to the patient.

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