Optum Rx, a pharmacy benefit manager of UnitedHealth Group, is dropping annual reauthorization requirements for 80 drugs, eliminating more than 10% of overall pharmacy prior authorizations. The move aims to simplify the process for doctors, pharmacists, and patients.
According to Patrick Conway, CEO of Optum Rx, these medications are no longer clinically necessary to review annually, including those used to treat cystic fibrosis, asthma, and other chronic diseases. This change will cut up to one-quarter of total drug reauthorizations, starting on May 1.
The decision is in response to customer feedback and the evolving healthcare landscape. Optum also announced earlier this year that it would pass 100% of negotiated drug rebates to its clients.
The move comes as the healthcare industry faces scrutiny over its use of prior authorizations. The public’s growing distrust of the industry, particularly after the killing of UnitedHealthcare CEO Brian Thompson, has contributed to increased pressure on companies like Optum Rx. The Trump administration is also expected to scrutinize Medicare Advantage insurers, including UnitedHealth Group, over billing and cost-related issues.
This change marks a shift towards simplifying healthcare processes, as lawmakers and regulators continue to push for reforms aimed at reducing bureaucracy and increasing transparency in the industry.
Source: https://www.axios.com/2025/03/19/optum-prior-authorization-prescription-drugs