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Optum Rx’s Humira biosimilar strategy for 2023 was set up to allow for the most value in the first year, said CEO Heather Cianfrocco.
Optum Rx saw revenue grow 9%, to almost $100 billion for 2022, according to United Healthcare’s 2022 earnings report. (Optum Rx is division of United Healthcare.) The company attributes the growth in the Optum Rx business to an expansion of its pharmacy services and new customers.
Company officials said in its regulatory filing that revenue and earnings from operations at Optum Rx increased due to higher script volumes from growth in people served, increased utilization and organic growth in pharmacy care services. Earnings from operations also increased as a result of continued supply chain and cost management initiatives.
In 2021, Optum Rx managed $112 billion in pharmaceutical spending, including $45 billion in specialty pharmaceutical spending.
Going forward, biosimilars will play an important role for Optum Rx, UnitedHealth Group’s chief executive officer Andrew Witty said in an investor call. “I am super pleased with the progress we’ve made in the biosimilars and within Optum Rx to deliver a contracting strategy which ensures that everybody who wants to use a Humira brand or biosimilar, we have a contracting strategy that will enable that right out of the gate,” he said. “We are passing back those benefits to the payers.”
In November, Optum Rx announced that it plans to include on its formularies Amgen’s Amjevita, a biosimilar of AbbVie’s blockbuster rheumatoid arthritis drug Humira (adalimumab), as well as two additional biosimilars. The new biosimilars will be available on the Select and Premium formularies.
Heather Cianfrocco, chief executive officer of Optum Rx, said in the earnings call that the Humira biosimilar strategy was set up to allow for the most value in the first year. “What’s important here is creating a marketplace with competition in a unique environment. With so many of the Humira biosimilars coming to the market in the next 18 months, our strategy allows them to compete based on the clinical criteria and product attributes, how the manufacturer supports the product, and the economics. The goal was choice without disruption.”
Witty also pointed to the importance of company’s life-saving drugs program, which offers zero dollar out-of-pocket costs for some short and long-acting insulins, as well as several drugs used to treat emergencies such as severe allergic reactions, hypoglycemia, opioid overdoses, and acute asthma attacks. He said so far, the program has been approved in 48 states for its fully-insured business, and one quarter of United Healthcare’s self-funded employers have now chosen to add this offering.
“We are guided in pharmacy by the principle of getting to the lowest cost for patients and clients,” Witty said.
The company indicated in a November call that it expected continued growth in pharmacy services, such as home delivery, specialty pharmacy, infusion services and community pharmacies. Optum Rx processes more than 1.4 billion adjusted scripts annually for more than 61 million people. Of these, 190 million scripts are delivered to consumer homes. Optum Rx manages about $124 billion in total prescription spend annually, including $52 billion in annual specialty pharmacy spend.