UnitedHealthcare broadens consumers direct rebate program | AP business

Henrietta Strickland
March 14, 2019

Drugmakers pay rebates to insurers and PBMs to lower the list price of prescription drugs in exchange for being included on their formularies, a list of approved drugs.

Insurance giant UnitedHealthcare said Tuesday that it will expand a program that passes drug discounts directly to consumers, a move that could lower costs for many who have struggled with high deductible payments and other out-of-pocket expenses.

Beginning in 2020, OptumRx and UnitedHealth will only support new employer clients that incorporate these point-of-sale discounts into their health plan design. But those discounts rarely flow directly to the people filling prescriptions.

Employers and insurers have typically used rebates to lower premiums for all members, and under the Trump plan, Medicare beneficiaries' drug-plan premiums are expected to rise slightly.

But those high list prices can hurt the patients buying the medications because what they have to pay for the drug out of pocket is based on that initial list price, not the after-rebate cost. That's generally small employers.

UnitedHealth's move builds on the existing discount programs that were announced a year ago, which the company said will serve more than 9 million consumers this year.

Just two months into the year, the existing program has already lowered prescription drug costs for consumers by an average of $130 per eligible 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.

Schumacher said the action UnitedHealthcare and OptumRx are taking will bring "real value" to consumers while lessening the impact of persistent drug price inflation.

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.

UnitedHealth Group (NYSE: UNH) is a diversified health care company dedicated to helping people live healthier lives and helping make the health system work better for everyone.

Other reports by Click Lancashire

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