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Specialty Pharma Solutions for Health Plans

Manage specialty medical drug expenses.

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Specialty Guidance Program

The Optum® Specialty Guidance Program (SGP) helps clients control specialty drug costs. It also gives providers evidence-based, payer-compliant clinical guidance to manage complex conditions effectively.

SGP includes1:

  • Online prior authorization portal and guideline library
  • Digitized clinical policies for over 50 specialty conditions
  • Ability to support all specialty drugs

Data management and analytics:

  • Over 14 million data points collected with more than 1 million data points for clinical guidance1

Optum expertise:

  • Over 29 million lives managed through the program1

Proven outcomes:

  • Average provider Net Promoter Score®: 621
  • 75% of requests entered by provider through SGP website1
  • Over 91% preferred product adoption1
  • Over 80% site of care adoption1

SGP focuses on specialty non-cancer conditions while Cancer Guidance Program (CGP) focuses on cancer conditions.

Quick facts

  

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Rising global spend

The projected specialty medicine spend by 20232 is $505 billion.

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High cost

The average cost of a specialty drug will be $84,000–$136,000 in 2023.3

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Increasing number of specialty drugs

The per member annual specialty spend is projected to reach $1,276 in 2023.4

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Additional insight

Medical knowledge doubles every 73 days.4

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Additional resources

White paper

Learn what’s new with the Specialty Guidance Program (SGP).

Download

White paper

We're keeping up with the ever-changing specialty drug market.

Download

White paper

Learn 5 things payers need to know about the looming biosimilars boom.

Download

Contact us

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Sources

  1. Optum book of business proprietary analysis. Results will vary by client.
  2. EvaluatePharma. Orphan Drug Report 2019. April 25, 2019. Accessed January 2023.
  3. PR Newswire. Global $568 billion specialty pharmaceuticals market to 2026: leverage the changing face of specialty pharmacy industry with flat world solutions. September 10, 2019. Accessed January 2023.