OptumRx is UnitedHealth Group’s freestanding pharmacy care services business, managing more than a billion prescriptions annually.
Through a more convenient, accessible and connected pharmacy experience, Walgreens and OptumRx will collaborate to deliver clients and members enrolled in the program an integrated pharmacy care offering. Benefits include the option to fill 90-day prescriptions at mail- order co-pay levels at any of Walgreens’ nearly 8,200 stores nationwide or through OptumRx home delivery.
The initiative also promises higher adherence rates and better outcomes by giving patients the choice of how to receive their medications, along with 24/7 pharmacist availability. Members will have access to clinical guidance that addresses specific disease classes and increases drug adherence.
The program also enables OptumRx and Walgreens systems to better connect and communicate health data and analytics to ensure that members receive the most effective prescription drugs at the right cost.
“OptumRx’s differentiated pharmacy care services model, creating smarter health care connections, will be a strong fit with the more than 27,000 Walgreens pharmacists who interact with and support millions of patients on a daily basis,” said Alex Gourlay, executive vice president of Walgreens Boots Alliance and president of Walgreens. “Together, we will build upon our complementary capabilities and shared vision to offer this new pharmacy solution delivering true value to the customers that we serve.”
“By integrating Walgreens industry-leading in-store pharmacy capabilities and convenient retail locations with OptumRx’s advanced pharmacy care services, we expect to create significant value for our clients and members,” said Larry Renfro, chief executive officer of Optum. “We are excited to be working with Walgreens to create a new pharmacy solution that provides convenience and cost savings, and goes beyond filling prescriptions to deliver a more valuable pharmacy and health management experience for consumers.”
The joint offering is also designed to meet the goals of payers and health care sponsors seeking to manage drug benefits better and address the rising cost of care.
OptumRx and Walgreens expect the new program to be available to commercial clients implementing new 90-day prescription benefit designs, starting January 1, 2017.
“By linking up with Walgreens’ broad retail network, OptumRx gains a viable multichannel option to compete with CVS Health,” said Adam Fein, president of Pembroke Consulting Inc. and CEO of Drug Channels Institute. “By becoming the preferred retail pharmacy for OptumRx’s PBM business, Walgreens gains incremental store traffic, albeit at a presumably reduced margin.”
Fein blogged that the deal validates CVS’ “channel-agnostic” Maintenance Choice program, which gives CVS/caremark plan members a choice of how they want to fill their prescriptions. They can fill 90-day scripts for chronic conditions through mail order or at any CVS/pharmacy, typically at the lower mail-order co-pay.
“Competing PBMs cannot readily match the Maintenance Choice program, because a separately owned PBM and pharmacy chain are always battling over the per-prescription dispensing profit,” noted Fein. “CVS Health, however, owns both channels, so it can adopt a ‘money doesn’t know where it comes from’ mantra.”
Walgreens and OptumRx now have a comparable offering, he emphasized. “At the very least we see this announced partnership as UnitedHealth catching up to its PBM industry peers,” Wells Fargo & Co. analyst Peter Costa wrote in a research note. “If priced well, it could even shift the landscape such that Express Scripts would be at a disadvantage and CVS could lose its current product advantage.”
The deal also raised doubts about the possibility of Express Scripts, the biggest PBM, establishing an alliance or even merging with Walgreens. “There are not a lot of players left, so Express Scripts is left standing when the music stopped,” said Fein.
“Pharmacy has become the land of the giants, with larger companies consuming all or part of the smaller players,” he added. “In a more integrated health care system, will the pure play PBM model lose relevance?”