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Ensuring equity in access to care is one of the most persistent challenges in health care.

Since the OptumRx mission is helping people live healthier lives and helping make the health system work better for everyone, we continue to work to identify and address the challenges related to disparities in care.

Health care disparities can be observed due to differences in race, ethnicity, gender, sexual orientation, age, disability status, socioeconomic status and geographic location. These disparities manifest themselves in many ways. For example, Hispanic and black people are more likely to be uninsured and delay treatment due to cost concerns.1 As a result, they incur higher rates of chronic disease and premature death compared to the rates among whites.

While these disparities have existed for decades, COVID-19 further exposed the problem.

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Source: Centers for Disease Control and Prevention. COVID-19 Racial and Ethnic Health Disparities: Figure 2

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At the level of pharmacy care services, OptumRx efforts to drive health equity focus on three key area areas: increasing affordability, improving access, and advocating for better practices.

Increasing affordability. Since pharmacy is such a critical component to health care, efforts to expand health equity need to encompass ways to make prescription drugs more affordable to those in need.

The OptumRx® Critical Drug Affordability Program works to lower prices for five key classes of medications considered life-sustaining, including insulins, anticoagulants and HIV treatments. For each class, we chose the lowest-cost option available and built it into a convenient plan. Clients can choose to bring the member cost-share down as low as $0, helping ensure that these critical medications are affordable for members.

An additional way OptumRx helps make drugs more affordable is with MyScript Finder.™This digital tool within the OptumRx member website and mobile app enables users to comparison shop for medications and look up prices at any time. The tool calculates the patient’s coinsurance or copay amount. It also suggests cost-saving alternative medications when clinically appropriate.

Another tool for helping make medication affordable is discount cards. The pandemic and resulting rise in unemployment caused many to lose health benefits including prescription drug coverage. The Optum Perks Prescription Relief Program is designed to provide discounts for people during a loss of insurance or prescription coverage. This free program works automatically for OptumRx members who are termed and have lapsed coverage and provides them with ongoing savings on prescriptions and continued access to mail order when their coverage ends.

Advocating for better practices. To better serve all populations, OptumRx product teams use health equity criteria as part of standard product development process. Likewise, to ensure equity discernment is part of any drug review, we are also incorporating known health disparities into drug reviews. and performing audits on existing solutions.

Moreover, we are working with our third-party pharmaceutical and therapeutics committees to ensure equity is considered at every stage of the product development process. We are also evaluating standard industry practices for bias. OptumRx is also leveraging our expertise in data and analytics to address disparities in care. This entails evaluating our clinical offerings for signals of health inequity to drive improvements.

Improving access. Ensuring affordable access to medication is vital to reducing disparities in care and outcomes. Offering lower costs and greater convenience, OptumRx home delivery of medications can boost medication adherence, which can contribute to improved outcomes. Genoa Healthcare, an Optum business that runs 600 pharmacies within community health clinics nationwide, is improving the quality of life for individuals living with behavioral health and other complex health issues.

In addition to nationwide initiatives, we are also working to improve access at the state and local level. In Arizona, we are leveraging expertise in specialty pharmacy to administer the Drug Assistance Program, a federally-funded program under the Ryan White Act. Designed to help vulnerable populations with unmet non-clinical needs, the program focuses on helping those with HIV/AIDS.

Compared to other races and ethnicities in the U.S., people of color account for a higher proportion of new HIV diagnoses and people living with HIV.2

In Kansas, OptumRx is providing pro bono access to medication. OptumRx leveraged its supply chain resources, legislative influence, and community relationships to develop the Kansas Drug Donation Program in partnership with the state of Kansas. In 2020, OptumRx donated $30M in unused medication.

Conclusion

As a leading provider of pharmacy care services, OptumRx has a key role to play when it comes to making health care more accessible and available to all. While we have made measurable progress, there is still much to be done. Beyond the key initiatives and examples outlined above, ongoing efforts to educate and engage the broader community of patients, providers and sponsors about the ways to address health inequities are vital.

To learn more about of ways OptumRx is tackling this challenge and what your organization can do, please reach out to your OptumRx representative.

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