Optum

Name

Optum

Legal name

Optum Inc.

Website

https://optumrx.com

Company type

Private

Founded year

1988

Operating status

Operating

Headcount range

5,001–10,000 employees

Ownership category

akta.pro rank

Product category

Pharmacy Benefit Management

NAICS

Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds (524292), Health and Welfare Funds (525120)

SIC

Insurance Agents, Brokers & Service (6411), Wholesale-Drugs, Proprietaries & Druggists' Sundries (5122)

akta.pro primary industry

PBM Technology Platforms (ePA/eRx/Real-Time Benefit Tools) (HLAEAKAL)

akta.pro secondary industries

Formulary Management & Clinical Pharmacy Programs (HLAEAKAA), Pharmacy Benefit Analytics, Reporting & Employer Consulting (HLAEAKAK), Pharmacy Benefit Management (PBM) & Formulary Management IT (HLACAKAD), Pharmacy Benefit Management (PBM) & Pharmacy Network Administration (HLAFALAI)

Keywords

• Pharmacy benefit management
• Specialty pharmacy services
• Home delivery pharmacy
• Infusion pharmacy services
• Healthcare clinical analytics

Headquarters

HQ city

San Antonio

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2B and B2C

Offering type

Services

Cost components

Personnel, Supply Chain, Operations, Technology or R&D, Infrastructure, Marketing or Sales

Revenue model

1. Pharmacy Benefit Management (PBM): Optum Rx operates as one of the Big Three PBMs, managing prescription drug benefits for health plans, employers, and government programs. Revenue comes from formulary management, rebate administration, and pharmacy network management.
2. Specialty Pharmacy Services: Specialty pharmacy services for complex therapies including cancer, autoimmune diseases, and inflammatory conditions with personalized patient care and clinical support.
3. Weight Engage Program: GLP-1 care program providing clinically supervised prescribing and wraparound support services for weight management, partnering with employers and health plans.

Pricing tiers

Go-to-market motion2 records

Distribution channels5 records

Marketing channels2 records

Core offering

Optum provides pharmacy benefit management (PBM) services through Optum Rx, administering prescription drug benefits, home delivery, specialty pharmacy, and infusion pharmacy for health plans, employers, and government programs. It complements these services with the HealthSafe ID authentication platform, the Optum Rx Mobile App, and the Optum.ai healthcare AI platform for clinical analytics and AI-enabled workflows. The company serves members across all 50 U.S. states and integrates pharmacy services with broader Optum health services capabilities.

Product overview

Optum is a health services company offering a comprehensive pharmacy ecosystem centered on Optum Rx, its pharmacy benefit management (PBM) platform. The core Optum Rx product provides prescription drug coverage, pharmacy network management, and medication pricing tools for members and employer clients. This core platform is augmented by complementary pharmacy services: Optum Specialty Pharmacy handles complex conditions (cancer, autoimmune diseases, multiple sclerosis), Optum Home Delivery Pharmacy offers mail-order prescription delivery, and Optum Infusion Pharmacy manages IV therapies. Supporting brands include divvyDOSE (pre-sorted medication packaging) and Genoa Healthcare (mental health pharmacy). The portfolio also includes the Weight Engage Program for GLP-1 weight management, Optum Payments Network for health benefits payments, and HealthSafe ID for secure member authentication across platforms.

Differentiator

Problem solved

Functional benefit

Brands

• Genoa Healthcare: Mental health and complex condition medication management services
• divvyDOSE
• Optum Labs

Products and services

• Optum Rx Pharmacy Benefit Management Pharmacy benefit management platform providing prescription drug coverage, home delivery pharmacy, pharmacy network management, drug pricing tools, and prior authorization support for health plans, employers, and individual members.
• Optum Specialty Pharmacy Specialty pharmacy service for complex conditions including cancer, Crohn's disease, ulcerative colitis, inflammatory arthritis, multiple sclerosis, and viral hepatitis, offering one-on-one clinical support, temperature-sensitive shipping, and virtual visits.
• Optum Home Delivery Pharmacy Mail-order prescription delivery service offering free standard shipping, 24/7 pharmacist access, automatic refill options, and temperature-controlled packaging for chronic condition medications.
• Optum Infusion Pharmacy Specialized pharmacy service for infusion therapies, enabling patients to manage IV treatments at home or through provider settings.
• divvyDOSE Medication management service that pre-sorts prescriptions by day and time and delivers them to patients' homes for improved adherence.
• Genoa Healthcare Pharmacy services for mental health and complex conditions, providing medication management and coordination for behavioral health patients.
• Frontier Therapies Rare disease medication management services helping patients access and manage treatments for uncommon medical conditions.
• Weight Engage Program GLP-1 weight loss drug program providing clinically supervised prescribing and wraparound support services for obesity treatment, delivered through partner organizations for employer and health plan populations.
• HealthSafe ID Identity verification and single sign-on system providing secure access to Optum health benefits information across multiple Optum platforms, with multi-step verification including member ID, social security number, and mobile phone verification.
• Optum Connections Virtual care platform offering scheduled virtual visits with care teams and video series featuring patients with similar conditions for education and support.

Quantifiable outcome

• $6,081 total cost of care savings per patient demonstrated through Oshi Health partnership with Optum Advisory
• +2 more outcomes

Named customers1 record

Segments4 records

Ideal customer profiles5 records

Technology focussed Yes

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

AI capability3 records

Feature4 records

Partnerships

Seven partnerships are on record, tiered core and minor.

• Omada HealthcoreGTM or Marketing Partner · 8 May 2026Omada Health partnered with Optum Rx to participate in its Weight Engage program for GLP-1 care offerings. This partnership addresses growing demand for GLP-1 weight loss drugs amid spotty coverage and adherence challenges. The expansion gives Omada relationships with all three largest PBMs and supports the company's growth trajectory while addressing employer demand for comprehensive cardiometabolic care solutions.
• Eli Lilly (Employer Connect Program)coreGTM or Marketing Partner · 8 May 2026Omada Health announced partnerships with Eli Lilly's Employer Connect program and Optum Rx's Weight Engage program for GLP-1 care offerings, expanding access to weight management treatments.
• CalibrateminorGTM or Marketing Partner · 5 May 2026Existing partner in the Weight Engage program alongside Omada Health, providing clinically supervised prescribing and wraparound support services for GLP-1 weight management.
• Virta HealthminorGTM or Marketing Partner · 5 May 2026Existing partner in the Weight Engage program alongside Omada Health, providing clinically supervised prescribing and wraparound support services for GLP-1 weight management.
• CDE SolutionscoreStrategic or Co-development Partner · 30 April 2026Strategic alliance with Optum Payments Network to expand S3 Health Benefits payment acceptance across a broader network of retail merchants nationwide. The collaboration combines CDE's merchant onboarding and payment processing capabilities with Optum's healthcare and benefits infrastructure to enable more retailers to accept S3 Health Benefits payments for eligible food and approved over-the-counter health products, helping Medicare Advantage members use their monthly S3 Health Benefits allowances.
• ANSRcoreStrategic or Co-development Partner · 3 April 2026ANSR partnered with Optum to launch the Healthcare GCC Accelerator Platform powered by advanced AI capabilities. The platform combines ANSR's end-to-end GCC execution model with Optum's healthcare AI technology through Optum.ai, designed to help healthcare enterprises build and scale AI-enabled capability centers. ANSR claims purpose-built AI platforms can drive 20-25% efficiency gains initially and up to 50-60% as capabilities mature, including 35+ automated workflows and a pipeline of 50-75 new AI use cases annually.
• Oshi HealthcoreStrategic or Co-development PartnerOshi Health, a virtual multidisciplinary GI clinic, partnered with Optum Advisory to conduct intervention vs. control analysis demonstrating $6,081 in total cost of care savings per patient and 5.9x return on investment. This partnership enabled Oshi Health to secure and outperform value-based contracts with commercial health plans.

Scale indicators5 records

Recent moves5 records

Expansion highlights5 records

Market position

Competitive moat6 records

Key risks4 records

Key highlights7 records

Customer concentration

• Xx.com/optum
• Facebookfacebook.com/myOptum
• LinkedInlinkedin.com/company/avella
• Instagraminstagram.com/optum

Compliance7 records

Revenue estimate

Valuation estimate

Number of profiles

Profiles3 records

Subsidiaries5 records

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Optum