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Eight Insulins Move to Preferred Formulary Tier on Optum Rx

Eight Insulins Move to Preferred Formulary Tier on Optum Rx

In a strategic move aimed at tackling affordability issues, Optum Rx has announced the transition of eight insulin products to its preferred formulary tier. This decisive step encompasses rapid-acting, short-acting, and select long-acting insulin products, including those manufactured by industry giants Sanofi, Novo Nordisk, and Eli Lilly.

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Shaping Affordability: The Drive Behind the Transition

Optum Rx, a key player in the pharmaceutical landscape, is redefining its approach to medication accessibility by addressing the pressing concern of soaring insulin prices. The company’s Tier 1, now hosting the newly incorporated insulins, guarantees the lowest cash prices for its members, a pivotal measure in enhancing affordability.

“I’ve seen firsthand how high prices for insulin and other necessary medications can cause patients to limit or skip doses,” expressed Patrick Conway, M.D., CEO of Optum Rx”Medication that people can’t afford is useless, and by taking this important next step to change our formulary, we will lower costs and improve access for more people who need this life-saving medication.”

“Medication that people can’t afford is useless.” Our objective is to lower the cost of all medications that are considered to be essential.

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Stepping Back to Move Forward: Optum Rx’s Recent Endeavors

This latest development builds upon Optum’s proactive initiatives from the previous year. In 2022, in collaboration with sister company UnitedHealthcare, Optum undertook efforts to reduce out-of-pocket costs on various drugs, including insulin, down to an impressive $0.

Simultaneously, a partnership with Sanofi was forged, enabling Optum to provide 30-day insulin supplies for uninsured diabetic patients at a minimal cost of $35.

Currently, 70% of Optum Rx members have access to insulin for $35 or less per month. With the impending program taking effect on January 1, this percentage is set to rise significantly to 97%, marking a substantial leap in affordable insulin availability.

Navigating the Drug Pricing Battlefield: The Role of Pharmacy Benefit Managers

In its official release, Optum emphasized the pivotal role of pharmacy benefit managers (PBMs) as a “counterweight” to pharmaceutical manufacturers in the ongoing battle over drug pricing. PBMs, including Optum Rx, have recently come under scrutiny in Congress as policymakers explore solutions to mitigate the escalating costs of prescription medications.

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“This formulary decision builds on a series of Optum Rx actions to help protect consumers from high and rising drug prices and provide them with more choices,” Optum remarked, emphasizing its commitment to proactive steps tackling the problems faced by expensive drug costs.

“This formulary decision builds on a series of Optum Rx actions to help protect consumers from high and rising drug prices and provide them with more choices,”

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The Road Ahead: Paving the Way for a More Accessible Medication Landscape

As the healthcare landscape continues to evolve, Optum Rx’s strategic move underscores the industry’s commitment to finding sustainable solutions for ensuring medication affordability.

By actively adjusting its formulary and collaborating with key players in the pharmaceutical domain, Optum Rx aims to set a precedent for prioritizing patients’ well-being over profit margins.


In conclusion, Optum Rx’s decision to shift eight insulin products to its preferred formulary tier marks a significant stride towards fostering accessibility and affordability in the realm of life-saving medications.

As the healthcare sector grapples with ongoing challenges, such initiatives are indicative of a collective effort to create a more inclusive and sustainable healthcare ecosystem.