UnitedHealthcare Broadens Consumers Direct Rebate Program

UnitedHealthcare appears to be the first major insurer to require new employer clients to apply rebates to consumers’ out-of-pocket expenses

UnitedHealthcare broadens direct drug rebate program

Pharmaceutical companies and insurers have come under scrutiny by the Trump administration and members of Congress, and have struggled to show that they are doing something to address high drug prices.

Building on the introduction of the first-of-its-kind point-of-sale discount program, OptumRx and UnitedHealthcare are expanding their innovative consumer point-of-sale prescription drug discount programs to apply to all new employer-sponsored plans, making medications more affordable and improving health outcomes.

Beginning in 2020, OptumRx and UnitedHealth will only support new employer clients that incorporate these point-of-sale discounts into their health plan design. Even though insurers and employers pay a lower net price (after rebates have been accounted for), many consumers have been forced to pay the equivalent of a drug's list price at the pharmacy when they have not yet met their annual deductible or when their plan requires that they contribute a percentage of a drug's price.

"Patients are seeing concrete benefits from UnitedHealthcare's groundbreaking point-of-sale discount program, which is just one element in our commitment to help deliver better health, lower costs and a better experience", said Daniel J. Schumacher, president and COO of UnitedHealthcare. Those are often passed on companies that sponsor employee insurance plans to lower everyone's premiums.

The trial program started January 1, 2019, and so far has resulted in an average of $130 per eligible prescription, says UnitedHealth.

Drug rebates have become a growing point of contention as the cost of medical care and prescription drugs rises. The federal government has said those hidden rebates can amount to up to 30 percent of a drug's list price.

Health and Human Services Secretary Alex Azar has pushed to turn them more into upfront discounts the customer gets when paying for the drug. He has said that would create pressure on drugmakers to keep prices down.

UnitedHealthcare is the insurance arm of UnitedHealth Group Inc., which is based in Minnetonka, Minnesota.

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