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UnitedHealth was accused by Louisiana’s attorney general of inflating prescription drug charges in the state’s Medicaid program by billions of dollars.
UnitedHealth’s pharmacy benefits manager, Optum Rx, used secret prices and the complexity of the supply chain to cause the safety-net health program “to needlessly pay billions of dollars more per year for prescription drug benefits,” according to a lawsuit from Attorney General Jeff Landry. The action was filed April 13 in state court.
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The legislation calls on Congress to lower prescription drug costs, shift subsidies directly to consumers, and enforce strict price transparency.
Employers are under pressure to keep benefits competitive while controlling costs, driving new scrutiny of PBMs, hospital prices and GLP-1 coverage for 2027.
Rising use of the weight-loss drug is fueling the fastest health plan cost growth in a decade and a half, forcing employers to rethink coverage strategies and cost management.
As healthcare costs continue climbing, employers are exploring new funding models, cost-containment strategies, and benefits approaches to better manage spending.
Part one of this two-part series looks at the background, transparency solutions and how to understand PBM profitability.
