Amid rising criticism of pharmaceutical pricing, UnitedHealth Group (UNH) will soon require employers that hire its OptumRx pharmacy benefit manager to pass rebates to the individuals who actually take the medicines.
Specifically, the insurer will ask employers that sign new contracts as of January 2020 to agree to the stipulation, although this will not apply to existing clients. However, the program will only encompass employer-sponsored plans that directly contract with OptumRx to administer pharmacy benefits. Patients will receive the discount for each eligible prescription, according to an OptumRx spokesman.
The move comes as debate intensifies over rebates, which are paid by drug makers to pharmacy benefit managers and insurers in order to win favorable placement on formularies — the lists of medicines that receive reimbursement. A portion of the rebates are kept by PBMs and health plans, while the remaining funds are sent to employers, which may use the money to lower premiums or lower costs.