March 19 (Reuters) - UnitedHealth Group's ( UNH )
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 ( UNH ) 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 ( UNH ) 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 ( UNH ) 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 ( CVS ) Caremark, Cigna's ( CI ) Express
Scripts and UnitedHealth's ( UNH ) 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.