Optum Rx is launching a new program that aims to integrate specialized care for women navigating menopause into the pharmacy benefit.
The program is a virtual-first offering that connects eligible women with clinicians that have been certified with the Menopause Society. Through the program, they can access both hormonal and nonhormonal therapies, symptom tracking, education and one-on-one patient coaching.
Tracy Spencer, senior vice president for product and strategy at Optum Rx, told Fierce Healthcare 50 million women are currently experiencing symptoms related to either perimenopause, menopause and post-menopause. And 40% of those women say those symptoms impact their work performance.
"This is an area that remains one of the most underserved in healthcare, which is why we're here today, because closing that gap for women's health is really important," Spencer said.
Optum initially piloted the program beginning at the end of 2025, and Spencer said that pilot ended in September. She said that participants in the pilot reported that on average they eliminated five symptoms related to menopause. Most (80%) of the women in the pilot saw an improvement in their symptoms, she said.
And beyond the symptoms directly linked to menopause, having a program in place that supports women during this phase of life can also mitigate the risk of developing future conditions like osteoporosis, diabetes, heart disease and Alzheimer's disease, said Spencer.
When a member enrolls in the program, they'll be given a personalized health assessment by the clinical team to determine what their treatment plan should look like. The Optum Rx clinicians work in tandem with the member's existing clinical team, including primary care doctors or gynecologists.
Members can also access a digital interface that allows them to track symptoms, access educational materials and connect with the support coaches, Spencer said.
"It's really meant as a complement to the woman's current care team," she said.
Menopause can also be a lengthy stage of life for many women, with some experiencing symptoms for a decade or more. Spencer said the median length for hot flashes and night sweats, for example, is seven years.
So the program is built to support women in the long term over their menopause health journey, Spencer said.
"The ability to have those ongoing resources that are accessible for women when they want to receive them, how they want to receive them, is incredibly important," she said. "We always feel it's important to meet the patient where they're at."