UnitedHealth's unit reduces renewal requirements for some prescription drugs

Published: 2025-03-19 08:34:35 ET UNH

(Reuters) -UnitedHealth Group's pharmacy benefit manager, Optum Rx, said on Wednesday it would ease requirements to get insurance authorization when renewing prescriptions on about 80 drugs, aiming to reduce the paperwork for patients and doctors.

The list, which could be expanded over time, will eliminate up to 25% of these reauthorization requirements and accounts for more than 10% of all such pharmacy authorizations, it said.

The killing of a UnitedHealth executive last December had set off an outpouring of complaints about insurance on social media, including its and other health insurers' requirements to seek their approval on medicines.

In January this year, UnitedHealth said during a conference call with investors that it would work with policymakers to reduce the frequency of prior authorizations required before a patient can access medical treatment in its Medicare business for people aged 65 and older or with disabilities.

Reauthorizations, or certain checks that patients need to go through to continue receiving their medications, are necessary for drugs that have safety concerns, or need ongoing monitoring for adjusting doses, or additional tests, UnitedHealth's unit said.

Newly approved drugs for diseases such as Alzheimer's require ongoing review, whereas with genetic conditions like cystic fibrosis, there is minimal additional value in reauthorizing a treatment, the company said.

Pharmacy benefit managers negotiate drug prices and create coverage lists for health plans, mainly for employers and the government. They pay pharmacies directly for prescription drugs under their agreed terms.

CVS Health's Caremark, Cigna's Express Scripts and UnitedHealth's Optum control the majority of the U.S. pharmacy benefit market, with their parent companies also operating health insurance and pharmacy businesses.

They have come under scrutiny for their role in driving up costs for drugs, and President Donald Trump has also said he wants to knock out these middlemen.

(Reporting by Sriparna Roy in Bengaluru; Editing by Shilpi Majumdar)