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In the US, where a system of quasi-private healthcare is in place, a formulary is a list of prescription drugs available to enrollees, and a tiered formulary provides financial incentives for patients to select lower-cost drugs. For example, under a 3-tier formulary, the first tier typically includes generic drugs with the lowest cost sharing ...
Catamaran Corporation (formerly SXC Health Solutions) is the former name of a company that now operates within UnitedHealth Group's OptumRX division (since July 2015). It sells pharmacy benefit management and medical record keeping services to businesses in the United States [3] and to a broad client portfolio, including health plans and employers. [4]
Optum, Inc. is an American healthcare company that provides technology services, pharmacy care services (including a pharmacy benefit manager) ...
As of 2023, PBMs managed pharmacy benefits for 275 million Americans and the three largest PBMs in the US, CVS Caremark, Cigna Express Scripts, and UnitedHealth Group’s Optum Rx, make up about 80% of the market share covering about 270 million people [4] [5] with a market of almost $600 billion in 2024.
The new model, Optum Rx Clear Trend Guarantee, will provide value-based pricing of drugs per member combining the cost of these medicines from various sources such as retail pharmacy, home ...
Pharmacy and Therapeutics (P&T) is a committee at a hospital or a health insurance plan that decides which drugs will appear on that entity's drug formulary.The committee usually consists of healthcare providers involved in prescribing, dispensing, and administering medications, as well as administrators who evaluate medication use. [1]
Formed in 2011, Optum says that it provides "data and analytics, pharmacy care services, population health, healthcare delivery, and healthcare operations". [78] It is organized into three businesses: OptumHealth – provides primary and secondary care. [78] [79] OptumInsight – provides data analytics, technology, and operations services. [78]
The Optum contracts, signed in 2015, contributed 16% of Cardinal's total revenue in fiscal year 2023, but the bulk of the shipments mainly comprised non-specialty medicines, Cardinal Health said.