Competition record
OptumRx
Deep profile · 1 linked library matter
OptumRx is the pharmacy benefit manager inside UnitedHealth, and it is the remaining respondent in the FTC insulin case. A proposed consent is awaiting Commission approval and is not a final order.
Overview
OptumRx builds formularies, negotiates rebates, and fills specialty drugs for UnitedHealthcare and for outside health plans. Insulin rebates are the FTC matter still open against it.
Express Scripts settled on 4 February 2026 and Caremark settled on 14 July 2026. OptumRx is the respondent left, and its proposed consent is waiting for the Commission.
Commission approval has not happened. The docket is still pending, and a proposed consent is not a final order.
Competition footprint
Formulary tier decides which insulin a plan covers cheaply and which one costs the patient more.
OptumRx's proposed consent cannot take effect until the Commission approves it.
The Express Scripts and Caremark settlements did not close the Optum portion of the docket.
Consumer & business angle
Patients on UnitedHealthcare and on client plans pay the insulin copay the OptumRx formulary sets.
Insulin manufacturers negotiate the rebate that pays for preferred placement.
What to watch
- Whether the Commission approves the OptumRx consent.
- What formulary changes that consent would require if approved.
Markets
pharmacy benefit management · insulin formularies · prescription drugs · retail pharmacy
Also known as: optumrx, optum rx, optum