Optum Specialty Fusion™ Launched To Streamline Care and Lower Costs

Optum announced the launch of Optum® Specialty Fusion™, a first-of-its-kind specialty medication management solution, to simplify care for patients with complex conditions and lower the cost of expensive specialty drugs.

Specialty medications are costly, hard to manage and covered under both medical and pharmacy benefits. All this, plus the volume of new drugs, make it hard for providers to keep up with the best treatment options and almost impossible for plan sponsors to control costs.

Optum® Specialty Fusion™ gives plan sponsors new control by equipping providers with real-time medical and pharmacy analytics, technology, and specialty expertise at the point of care. Specialty Fusion was designed to streamline and simplify the medication management process.

Using Specialty Fusion, care providers can initiate the approval process for specialty drugs requiring prior authorization using a single portal. Treatment options are then compared against dozens of clinically appropriate, lower-cost options across benefits in seconds.

Specialty Fusion eliminates the need for a cross-benefit prior authorization process – a burden for providers – and secures treatment approval in real time. This reduces administrative hassle and results in an expected 50% faster access to therapy for patients, while lowering costs. Optum Specialty Fusion is now available to all large health plans.

Strong collaboration between Optum and UnitedHealthcare and its many external customers has helped the company grow in the commercial and government markets. OptumRx’s specialty and home delivery business are contributing to this growth.

Growth in specialty has been from rate of capture and its PBM clients who have been increasingly using the specialty service and are benefiting from the company’s investment in automation in digital and a better consumer experience.

OptumRx is processing and filling more than 80% of prescriptions the same day which will continue to improve both cost per script and refill cost per script. OptumRx also anticipates growth opportunities from the pipeline of specialty generic coming to the market and additional brands in specialty classes and biosimilar. Development of Emisar Pharma Services, Optum’s new group purchasing organization (GPO) will also contribute to growth.


Takeaway: Optum Specialty Fusion™ was launched to streamline treatment decision-making for care providers, helping patients get on their therapies faster