UnitedHealth Group’s pharmacy benefit manager, Optum Rx, announced on Wednesday that it will relax requirements for insurance authorization when renewing prescriptions for approximately 80 medications, starting May 1. The changes aim to reduce paperwork for patients and doctors.
According to Patrick Conway, CEO of Optum Rx, the emphasis is on adherence rather than frequent reauthorizations, particularly for chronic conditions like cystic fibrosis, asthma, and diabetes. This move is expected to be positively received by lawmakers who have scrutinized prior authorization practices in state and federal legislatures last year.
The list of affected medications includes Aimovig (migraine treatment), Kalydeco (cystic fibrosis treatment), and Praluent (high cholesterol treatment). The program will initially eliminate up to 25% of reauthorization requirements, accounting for more than 10% of all pharmacy authorizations.
The change is seen as a step towards reducing administrative burdens on healthcare providers and patients. It comes amid growing concerns about the cost of prescription drugs in the US.
Optum Rx’s decision has been welcomed by lawmakers and experts alike, with some even suggesting that similar changes could be implemented across medical services to further reduce bureaucratic hurdles.
Source: https://www.reuters.com/business/healthcare-pharmaceuticals/unitedhealths-unit-reduces-prescription-reauthorization-requirements-by-up-25-2025-03-19