Optum Rx announced Wednesday that it will eliminate up to 25% of reauthorizations, initially focusing on 80 drugs.
The pharmacy benefit management arm of UnitedHealth Group said it will work with physicians and pharmacists to identify further drugs to include over time.
Eliminating reauthorizations, a particular model of prior authorization, on these initial products accounts for about 10% of total prior authorization requests for the PBM.
“Optum Rx is taking meaningful steps to simplify patient experiences and increase access to critical medications,” said Patrick Conway, M.D., CEO of Optum Rx, in the press release. “These changes mean easier access to medications for consumers, less work for pharmacists and physicians and a simplified system focused on clinical quality.”
While the PBM is reducing prior authorization, in the announcement, the company does underscore the need for reviews for certain products.
For example, recently introduced drugs for Alzheimer's disease still carry significant questions around risks and long-term effectiveness, Optum Rx said.
By contrast, should a patient have a confirmed diagnosis for a condition like cystic fibrosis, there is limited value in requiring reauthorization for proven treatments, the PBM said.
"Medication authorizations are important for ensuring safe, appropriate, evidence-supported use of drugs," per the press release. "Some reauthorizations are necessary for drugs that have safety concerns, need ongoing monitoring for dose adjustments, require additional tests or may have alternative therapy considerations."
Beyond the updates announced Wednesday, Optum highlighted other steps it has taken to ease cost barriers for its members. The Optum Savings IQ program, for instance, pairs eligible specialty pharmacy customers with financial resources and programs that can lower their costs.
Through this offering, Optum said it saved members $1.3 billion in 2024, cutting the average out-of-pocket cost to $5.
It has also launched price comparison tools and savings alerts that can identify lower prices or potential discounts to benefit customers.