Optum Rx Responds to FTC Action

Following today’s FTC administrative action on insulin, Optum Rx has issued the following statement:

This baseless action demonstrates a profound misunderstanding of how drug pricing works. For many years, Optum Rx has aggressively and successfully negotiated with drug manufacturers and taken additional actions to lower prescription insulin costs for our health plan customers and their members, who now pay an average of less than $18 per month for insulin.

Since 2015, insulin has been offered on our Preventive Drug List for plan sponsors utilizing high deductible health plans to help them reduce member out of pocket costs to as low as $0. Optum Rx also offers low-cost insulin for $35 per month for those without insurance. PBMs, like Optum Rx, are the key counterweight to pharmaceutical companies’ otherwise unchecked monopoly power to set and raise drug prices.

Additional actions taken to lower insulin costs:

• Historically, Optum Rx has offered multiple insulin products on its standard commercial formularies and in January placed eight preferred insulin products on tier one, which will lower out-of-pocket costs for members in plans adopting those formularies.
• Optum Rx has offered $35 insulin since 2020, as part of its Critical Drug Affordability list, which today includes 290 brand and generic medicines with low or $0 cost sharing.
• Optum Rx supported UnitedHealthcare fully insured plans to eliminate out-of-pocket costs on several critical prescription drugs, including insulin.
• Many of our health plan partners have funded insulin at $35 or less for senior and commercial plans for years, which Optum Rx administers as their PBM.