Optum Rx puts emphasis on predictability with new pricing model

Optum Rx is rolling out a new pharmacy model that seeks to make drug costs more predictable and transparent for clients.

The Optum Rx Clear Trend Guarantee aligns guarantees into single per member cost, encompassing retail, home delivery, specialty drug and rebate components in one guarantee. It provides an alternative to Optum's Cost Made Clear offering, which includes pass-through models and cost-plus pricing.

Optum said in an announcement that the Clear Trend initiative allows plan sponsors to more readily access a pharmacy payment that supports more effective spending management. This will create more predictability for members and their families around costs and premiums, the company said.

Clear Trend Guarantee will be available on Jan. 1 alongside the existing Cost Made Clear program, Optum said.

"It is more important now than ever before to be an innovator in health care and to drive affordability and value for plan sponsors and members," Optum Rx CEO Patrick Conway, M.D., said in the press release. "We are not stopping with Clear Trend Guarantee, and will continue to deliver clear information, transparent and lowest net cost, choice and a simplified pharmacy benefit for everyone."

The announcement notes that spending on drugs in the U.S. continues to rise, topping $711 billion at present and expected to reach $1 trillion by 2028. Optum said plan sponsors save 27% using its in-network rates, reducing costs by about $43 billion in aggregate each year.