UnitedHealth to expand use of point-of-sale drug discounts

UnitedHealth Group is expanding its point-of-sale discounts for drugs, the insurer announced Tuesday. 

Beginning in 2020, all new employer plans with UnitedHealth and its pharmacy benefit manager subsidiary Optum will be required to offer all drug discounts directly to members at the pharmacy counter, the insurer said

Deals in place with current employer clients, including those set to begin Jan. 1, will be grandfathered, UnitedHealth said. The insurer first announced it would expand its use of point-of-sale discounts a year ago, and said in the announcement that it will reach 9 million members with these benefits in 2019. 

“Patients are seeing concrete benefits from UnitedHealthcare’s groundbreaking point-of-sale discount program, which is just one element in our commitment to help deliver better health, lower costs and a better experience,” Daniel Schumacher, president and chief operating officer of UnitedHealthcare, said in a statement. 

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Employers who already contract with UnitedHealth and Optum can take advantage of this new plan design when they renew their deals, UnitedHealth said. 

Already this year, the point-of-sale discounts have saved UnitedHealth plan members an average of $130 per prescription, the insurer said. In addition, for people enrolled in plans without deductibles or high out-of-pocket costs, these discounts have improved medication adherence between 4% and 16%. 

Under pressure amid the ongoing debate over rising drug costs, insurers and PBMs have begun to turn to point-of-sale discounts instead of the traditional pricing rebates. Doing so addresses a major criticism from policymakers and drug companies: that PBMs and payers pocket many of the discounts on medications instead of passing them on to consumers. 

The Trump administration has taken steps to sunset the existing rebate system entirely. It issued a proposed rule in late January that would end legal protections for rebate negotiations and instead extend them to point-of-sale discounts in federal programs. 

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Congress is poised to weigh in as well, with a new Senate bill aiming to end the legal protections for rebates in the commercial sector as well. The Department of Health and Human Services expects its rule, if finalized to have ripple effects in the private market even if Congress doesn’t act. 

In the announcement, UnitedHealth said that point-of-sale rebates were an option in all of its employer plans before, but it believes the latest expansion will grow the program’s reach across its commercial insurance business, including to self-funded plans. 

“Together with employer partners and OptumRx, UnitedHealthcare has taken innovative action, bringing real value to consumers while mitigating the impact of persistent drug inflation brought on by drug manufacturers affecting consumers’ ability to afford medications and comply with their physicians’ treatment plans,” Schumacher said.