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Together, we are addressing health holistically

2024 Annual Health Care Trends Report

Get expert analysis for C-suite health care leaders on the forces driving change.

Insights

Browse insights on making the health system work better for all

Making health screenings more convenient

The pandemic has changed how people get care. At-home kits meet people where they live.

Formulary drug lists

Optum Rx helps minimize patient disruption during formulary cycle updates and throughout the year. Use the lists below to find coverage information.

Pharmacy Passages

Pharmacy Passages is an Optum Rx publication listing monthly updates to our standard formularies. For updates specific to health plans and custom drug lists, please check with the member's prescription benefit plan.

May 2025 IssueDownload
April 2025 IssueDownload
March 2025 IssueDownload
February 2025 IssueDownload
January 2025 IssueDownload
December 2024 IssueDownload

May 2025 IssueDownload
April 2025 IssueDownload
March 2025 IssueDownload
February 2025 IssueDownload
January 2025 IssueDownload
December 2024 IssueDownload

Formulary & UM updates

These updates may include exclusions, tier changes, prior authorizations, quantity limits and/or step therapy.

 

Important biosimilars update for 7/1/2025

Optum Rx includes biosimilars in our formulary strategy. View our Provider Biosimilars eToolkit for additional guidance.

July 1, 2025 updates

Prior authorization


Step therapy


Quantity limits


Combined flyer

January 1, 2025 updates

Supporting your patients

During formulary cycle updates, Optum Rx reaches out to impacted patients with the information they need, including suggested covered alternative medications. We’re here to support you and your patients through this process.

Here are a few things you can do to help make the transition smoother for your patients:

  • Reach out to your patient
    Or they may be contacting you with questions.
  • Discuss their options
    Determine if other covered medications could benefit the patient.
  • Select the medication
    If alternative medication is selected, send us an e-prescription. (Send CancelRx for the affected medication.)
  • Sticking with their current medication?
    A prior authorization may be required. Visit go.covermymeds.com/optumrx to submit.

Certain states require Optum Rx to communicate prior authorization changes before the effective date. Flyers are sent to members to outline the drugs affected by prior authorization, quantity limits, and step therapy based on benefit plan designs. Please review each document for more details.

Please note: these changes may not reflect final P&T Committee determinations. These changes are specific to prescription drug benefits only, and do not reflect changes that may occur at the health plan level. Prescribers are strongly encouraged to check with the health plan for other changes that may occur.