Healthcare DIVE March 21, 2025
The massive PBM is pivoting to a cost-based reimbursement model, which it says will reduce variation in how pharmacies are paid. Pharmacy groups say that depends on the specifics of Optum Rx’s plan.
Dive Brief:
- Optum Rx is shifting to a new pharmacy reimbursement model that should result in pharmacies being paid more for brand-name drugs and less for generics. It’s the latest move from a major drug middleman to reform how pharmacies are paid amid widespread criticism of the status quo.
- Optum Rx said Thursday that it would pay pharmacies in a cost-based model, which should give them more reliable revenue and allow them to stock more drugs, also helping consumers access their medications.
- The massive pharmacy benefit...
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