All Optum® trademarks and logos are owned by Optum, Inc. All other brand or product names are trademarks or registered marks of their respective owners.

© 2016 Optum, Inc. All rights reserved. ORX9134_160202

Specialty conditions overviewPrevalence and cost

1. Approximate annual AWP cost per patient of top utilized drugs for UHC — calendar year 2014/2015.

Click on the vials to learn more about these specialty conditions.

All Optum® trademarks and logos are owned by Optum, Inc. All other brand or product names are trademarks or registered marks of their respective owners.

© 2016 Optum, Inc. All rights reserved. ORX9134_160202

Growth hormone deficiency A condition in which there is inadequate

secretion of growth hormone from the anterior pituitary gland.

1. Approximate annual AWP cost per patient of top utilized drugs for UHC — calendar year 2014/2015.

4.19 prevalence per 10K lives

$ 40K–$65K average annual cost of drug therapy1

treatment is both

long and short term

All Optum® trademarks and logos are owned by Optum, Inc. All other brand or product names are trademarks or registered marks of their respective owners.

© 2016 Optum, Inc. All rights reserved. ORX9134_160202

4.19 prevalence per 10K lives

$ 40K–$65K average annual cost of drug therapy1

Multiple medications have the same active ingredient

treatment is both

long and short term

Pharmacy only (100%)

Medical + pharmacy

Medical only

Total drug cost by benefit

100%

1. Approximate annual AWP cost per patient of top utilized drugs for UHC — calendar year 2014/2015.

Growth hormones are primarily used by

children

Top three medications*:• Nutropin • Saizen • Genotropin

*by spend

Growth hormone deficiency A condition in which there is inadequate

secretion of growth hormone from the anterior pituitary gland.

All Optum® trademarks and logos are owned by Optum, Inc. All other brand or product names are trademarks or registered marks of their respective owners.

© 2016 Optum, Inc. All rights reserved. ORX9134_160202

Hemophilia

1. Approximate annual AWP cost per patient of top utilized drugs for UHC — calendar year 2014/2015.

2. “Hemophilia Data & Statistics.” Centers for Disease Control and Prevention. CDC, 26 Aug. 2014. Web. 22 Sept. 2014

A bleeding disorder that prevents the blood from clotting properly.

0.85 prevalence per 10K lives

$ 400K– $750K average annual cost of drug therapy1

treatment is

long term

All Optum® trademarks and logos are owned by Optum, Inc. All other brand or product names are trademarks or registered marks of their respective owners.

© 2016 Optum, Inc. All rights reserved. ORX9134_160202

Hemophilia A bleeding disorder that prevents the blood from clotting properly.

0.85 prevalence per 10K lives

$ 400K– $750K average annual cost of drug therapy1

Pharmacy only (81%)

Medical + pharmacy (5%)

Medical only (14%)

Total drug cost by benefit

Severity varies:60% have severe hemophilia25% have mild hemophilia15% have moderate hemophilia

20,000Americans affected2

treatment is

long term

1. Approximate annual AWP cost per patient of top utilized drugs for UHC — calendar year 2014/2015.

2. “Hemophilia Data & Statistics.” Centers for Disease Control and Prevention. CDC, 26 Aug. 2014. Web. 22 Sept. 2014

Top three medications*:• Advate • Kogenate • Recombinate

Either on-demand (as needed) or preventive treatment

xx

xxx

*by spend

All Optum® trademarks and logos are owned by Optum, Inc. All other brand or product names are trademarks or registered marks of their respective owners.

© 2016 Optum, Inc. All rights reserved. ORX9134_160202

Hepatitis CA chronic infection that can cause severe liver disease and is a common reason for needing a liver transplant.

1. Approximate annual AWP cost per patient of top utilized drugs for UHC — calendar year 2014/2015.

2. Hepatitis C Fact Sheet. Centers for Disease Control and Prevention Department of Health & Human Services. June 2010.

3. http://www.nytimes.com/2014/10/11/business/harvoni-a-hepatitis-c-drug-from-gilead-wins-fda-approval.html?_r=0.Accessed June 2, 2015.

treatment is

short term

$ 95K–$150K average annual cost of drug therapy1 2.87

prevalence per 10K lives

All Optum® trademarks and logos are owned by Optum, Inc. All other brand or product names are trademarks or registered marks of their respective owners.

© 2016 Optum, Inc. All rights reserved. ORX9134_160202

Hepatitis CA chronic infection that can cause severe liver disease and is a common reason for needing a liver transplant.

1. Approximate annual AWP cost per patient of top utilized drugs for UHC — calendar year 2014/2015.

2. Hepatitis C Fact Sheet. Centers for Disease Control and Prevention Department of Health & Human Services. June 2010.

3. http://www.nytimes.com/2014/10/11/business/harvoni-a-hepatitis-c-drug-from-gilead-wins-fda-approval.html?_r=0.Accessed June 2, 2015.

treatment is

short term

Pharmacy only (100%)

Medical + pharmacy

Medical only

Total drug cost by benefit

100%

A 12-week treatment of Harvoni costs approximately $94,5003

Treatment can range from 8–24 weeks

Top three medications*:• Harvoni • Olysio • Sovaldi

*by spend

3.2 millionAmericans infected, most are unaware2

17,000 Americans become infected each year2

$ 95K–$150K average annual cost of drug therapy1 2.87

prevalence per 10K lives

All Optum® trademarks and logos are owned by Optum, Inc. All other brand or product names are trademarks or registered marks of their respective owners.

© 2016 Optum, Inc. All rights reserved. ORX9134_160202

HIV Human immunodeficiency virus (HIV) attacks the cells of the immune system so that it can’t fight off infections and disease. Advanced stages of HIV can lead to acquired immunodeficiency syndrome (AIDS).

1. Approximate annual AWP cost per patient of top utilized drugs for UHC — calendar year 2014/2015.

2. http://www.cdc.gov/hiv/basics/statistics.html. Accessed May, 2015.

25.30 prevalence per 10K lives

$ 30K–$40K average annual cost of drug therapy1

treatment is

long-term

All Optum® trademarks and logos are owned by Optum, Inc. All other brand or product names are trademarks or registered marks of their respective owners.

© 2016 Optum, Inc. All rights reserved. ORX9134_160202

HIV Human immunodeficiency virus (HIV) attacks the cells of the immune system so that it can’t fight off infections and disease. Advanced stages of HIV can lead to acquired immunodeficiency syndrome (AIDS).

25.30 prevalence per 10K lives

$ 30K–$40K average annual cost of drug therapy1

1.2 millionAmericans affected2

Pharmacy only (100%)

Medical + pharmacy

Medical only

Total drug cost by benefit

100%

1. Approximate annual AWP cost per patient of top utilized drugs for UHC — calendar year 2014/2015.

2. http://www.cdc.gov/hiv/basics/statistics.html. Accessed May, 2015.

treatment is

long-term

Top three medications*:• Atripla • Truvada • Striblid

*by spend

A combination of drugs is used for the best control. Almost all therapies are oral. There are some generics.

Single tablet regimens exist today; there are multiple options

All Optum® trademarks and logos are owned by Optum, Inc. All other brand or product names are trademarks or registered marks of their respective owners.

© 2016 Optum, Inc. All rights reserved. ORX9134_160202

Inflammatory conditions

Inflammatory conditions include rheumatoid arthritis, Crohn’s disease and psoriasis. They occur when the body attacks healthy tissue and cells, causing excessive and painful inflammation.

1. Approximate annual AWP cost per patient of top utilized drugs for UHC — calendar year 2014/2015.

2. Questions and Answers About Rheumatic Diseases. National Institute of Arthritis and Musculoskeletal and Skin Diseases, Apr 2012. Web. 23 Jul 2014.

$ 40K–$65K average annual cost of drug therapy1 52.87

prevalence per 10K lives

treatment is

long term

All Optum® trademarks and logos are owned by Optum, Inc. All other brand or product names are trademarks or registered marks of their respective owners.

© 2016 Optum, Inc. All rights reserved. ORX9134_160202

Inflammatory conditions

Inflammatory conditions include rheumatoid arthritis, Crohn’s disease and psoriasis. They occur when the body attacks healthy tissue and cells, causing excessive and painful inflammation.

$ 40K–$65K average annual cost of drug therapy1

Pharmacy only (70%)

Medical + pharmacy (3%)

Medical only (27%)

Total drug cost by benefit

52.87 prevalence per 10K lives

46 millionAmericans affected2

treatment is

long term

Top three medications*:• Enbrel • Humira • Remicade

Most therapies are injections, some are now orals.

*by spend

1. Approximate annual AWP cost per patient of top utilized drugs for UHC — calendar year 2014/2015.

2. Questions and Answers About Rheumatic Diseases. National Institute of Arthritis and Musculoskeletal and Skin Diseases, Apr 2012. Web. 23 Jul 2014.

The #1 pharmacy and #2 medical benefit specialty category*

*by spend

All Optum® trademarks and logos are owned by Optum, Inc. All other brand or product names are trademarks or registered marks of their respective owners.

© 2016 Optum, Inc. All rights reserved. ORX9134_160202

Multiple sclerosis

Multiple Sclerosis (MS) is a condition in which the immune system attacks the protective sheath (myelin) of the nerves. This disrupts the flow of information within the brain, and between the brain and body.

1. Approximate annual AWP cost per patient of top utilized drugs for UHC — calendar year 2014/2015.

2. “FAQs about MS.” National MS Society. National Multiple Sclerosis Society, n.d. Web. 22 Jan. 2014.

15.48 prevalence per 10K lives

$ 65K–$75K average annual cost of drug therapy1

treatment is

long term

All Optum® trademarks and logos are owned by Optum, Inc. All other brand or product names are trademarks or registered marks of their respective owners.

© 2016 Optum, Inc. All rights reserved. ORX9134_160202

Multiple sclerosis

A condition in which the immune system attacks the protective sheath (myelin) of the nerves. This disrupts the flow of information within the brain, and between the brain and body.

The #2 pharmacy and #5 medical benefit specialty category*

*by spend

$ 65K–$75K average annual cost of drug therapy1

treatment is

long term

Top three medications*:• Copaxone • Tecfidera • Tysabri

Most therapies are injections, some are now orals.

*by spend

Pharmacy only (88%)

Medical + pharmacy (4%)

Medical only (9%)

Total drug cost by benefit

1. Approximate annual AWP cost per patient of top utilized drugs for UHC — calendar year 2014/2015.

2. “FAQs about MS.” National MS Society. National Multiple Sclerosis Society, n.d. Web. 22 Jan. 2014.

15.48 prevalence per 10K lives

All Optum® trademarks and logos are owned by Optum, Inc. All other brand or product names are trademarks or registered marks of their respective owners.

© 2016 Optum, Inc. All rights reserved. ORX9134_160202

OncologyCancer is the general name for a group of more than 100 diseases which start when mutations damage cellular DNA. Freed from their natural life cycle, damaged cells can grow in an unrestricted way that can form tumors and spread.2

1. Approximate annual AWP cost per patient of top utilized drugs for UHC — calendar year 2014/2015.

2. American Cancer Society: What Is Cancer? Available at: http://www.cancer.org/cancer/cancerbasics/what-is-cancer. Accessed 02/10/2014.

3. American Cancer Society. Cancer Facts & Figures 2014.4. National Cancer Institute. Questions and Answers: Annual Report to

the Nation on the Status of Cancer, 1975–2010. http://www.cancer.gov/newscenter/newsfromnci/2013

83.22 prevalence per 10K lives

$50K– $100K+ average annual cost of drug therapy1

All Optum® trademarks and logos are owned by Optum, Inc. All other brand or product names are trademarks or registered marks of their respective owners.

© 2016 Optum, Inc. All rights reserved. ORX9134_160202

Top three medications*:• Rituxan • Avastin • Herceptin

*by spend

OncologyCancer is the general name for a group of more than 100 diseases which start when mutations damage cellular DNA. Freed from their natural life cycle, damaged cells can grow in an unrestricted way that can form tumors and spread.2

83.22 prevalence per 10K lives

$50K– $100K+ average annual cost of drug therapy1

1. Approximate annual AWP cost per patient of top utilized drugs for UHC — calendar year 2014/2015.

2. American Cancer Society: What Is Cancer? Available at: http://www.cancer.org/cancer/cancerbasics/what-is-cancer. Accessed 02/10/2014.

3. American Cancer Society. Cancer Facts & Figures 2014.4. National Cancer Institute. Questions and Answers: Annual Report to

the Nation on the Status of Cancer, 1975–2010. http://www.cancer.gov/newscenter/newsfromnci/2013

More than 1.6 millionAmericans diagnosed in 20143

Lifetime risk of cancer in US:4

1 in 3 women 1 in 2 men

Pharmacy only (20%)

Medical + pharmacy (20%)

Medical only (60%)

Total drug cost by benefit

All Optum® trademarks and logos are owned by Optum, Inc. All other brand or product names are trademarks or registered marks of their respective owners.

© 2016 Optum, Inc. All rights reserved. ORX9134_160202

1. Approximate annual AWP cost per patient of top utilized drugs for UHC — calendar year 2014/2015.

2. Peacock AJ, Murphy NF, McMurray JJV, et al. An epidemiological study of pulmonary arterial hypertension. Eur Respir J 2007;30:104–9.

PAH Pulmonary arterial hypertension (PAH) causes stress on the heart due to increased blood pressure in the pulmonary arteries.

1.39 prevalence per 10K lives

$25K– $100K average annual cost of drug therapy1

All Optum® trademarks and logos are owned by Optum, Inc. All other brand or product names are trademarks or registered marks of their respective owners.

© 2016 Optum, Inc. All rights reserved. ORX9134_160202

PAH Pulmonary arterial hypertension (PAH) causes stress on the heart due to increased blood pressure in the pulmonary arteries.

1. Approximate annual AWP cost per patient of top utilized drugs for UHC — calendar year 2014/2015.

2. Peacock AJ, Murphy NF, McMurray JJV, et al. An epidemiological study of pulmonary arterial hypertension. Eur Respir J 2007;30:104–9.

Top three medications*:• Letairis • Tracleer • Remodulin

1.39 prevalence per 10K lives

Pharmacy only (65%)

Medical + pharmacy (25%)

Medical only (10%)

Total drug cost by benefit

Most members start on oral medications but, depending on severity, switch to multiple medications including infusions and inhaled and oral treatments.

15–50affected per million2

treatment is

long termWith no cure, treatment focuses on decreasing symptoms and improving quality of life

*by spend

$25K– $100K average annual cost of drug therapy1