1. OptumRx Smart Fill Program

2. Split Fill (1/2 Monthly Supply)
Smart Fill Overview
Unstable on medication
Stable on medication
Oral Oncology
HIV, MS, RA, Transplant
Increased clinical oversight
Improved satisfaction
Avoid waste
Member convenience
Patient Stability
Conditions/Drugs
Member Experience
Program Intent
Split Fill (1/2 Monthly Supply)
90-Day Supply
Adjust to medication
Adherence
Clinical Intent
6 fills over first 3 months
4 fills over 12 months
# Fills/Duration
½ copay
3x copay
Copays
No (mandatory)
Yes (voluntary)
Opt in
Program Offering

3. Smart Fill Optimizes Medication Fulfillment To The Clinical Needs Of The Member
Split Fill Program
90-Day Supply Program
Certain conditions have serious side effects that may cause some members to discontinue use.
Longer fills are good for members that have stable conditions and are well maintained on therapy.
For the first three months:
½ of regular prescribed supply limit
½ of regular copay
After 6 months of therapy:
90-day fill
3x copay

4. Split Fill – Oncology Medications: High Discontinuation
Toxic Side Effects from Oral Oncology Medications Lead to High Discontinuation Rates .
Standard Split Fill Drug List
49%*
Discontinue therapy within 90 days
Afinitor®
Nexavar®
Sprycel®
Sutent®
Tarceva®
Impacted Oral Oncology Drugs
Targretin®
Tasigna®
Votrient®
Zolinza®
Increased Waste of Medications .
*Based on UHC and OptumRx member population.

5. Oral Oncology Split Fill Program
Waste Avoidance Through Filling 2x per Month .
Current Fulfillment
One fill per month
Split Fill Program
Two fills per month
Prorated copay
Potential for early discontinuation due to intolerance
Side effects impact adherence
Member stops taking medication
Remaining drug on hand is wasted
Increased patient engagement
More frequent touch points (2x/ month)
Education
Adherence monitoring
Early identification of adverse events
Regular patient/provider communication
Reduced drug waste and realization of accompanying savings

6. 90 Day Supply Member Experience
90-Day Fill
Member Outreach
Members adherent for six months are given option to receive 90-day supply
Member Declines 90-day
Member Chooses 90-day
Care coordinator contacts every three months
Screen for adherence
Care coordinator contacts once per month
Screen for adherence
Program requirements
• Exclusivity required for individual or combined program offering
• Program offered as a bundle only (Split Fill + 90-Day Supply)
Pricing options
• Standard: No charge for bundle offering.
• Non-standard: $70 per Split Fill Rx fee for clients opting for Split Fill only