UNH · Forward model · Optum Rx
What has to happen in Optum Rx
Model as of
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Optum Rx
Basis quarter$38.29B
Final quarter$44.34B
Implied CAGR+3%
Final revenue mix36%
Pharmacy care services: revenue is adjusted scripts times revenue per script, both disclosed or directly derivable, and the two guided 2026 floors are internally consistent at $99.01 per script. Script volume follows the membership it serves, which is falling - 387 million scripts in the basis quarter against 414 million a year earlier - while revenue per script follows drug mix, which is rising.
Last four quarters
2025 Q3
$39.68B
Reported
2025 Q4
$41.46B
Reported
2026 Q1
$35.74B
Reported
2026 Q2
$38.29B
Reported
Pharmacy benefit managementHome delivery, specialty and community pharmacyPrivate label / specialty genericsFee-based transparent pricing model
Adjusted scripts
388940000/qtr
growing −0.6% per quarter
387m scripts reported in 2Q26 divided by the 0.995 Q2 factor; with seasonality on, the driver runs deseasonalised.
Revenue per script
$99
drifting +0.7% per quarter
$98.95 = 2Q26 revenue $38,292M / 387m scripts. The two guided 2026 floors imply $99.01, within 0.1%.
Optum Rx
Latest: $44.34B (2031Q2E)
| Period | Value |
|---|---|
| 2023Q2 | $28.65B |
| 2023Q3 | $28.86B |
| 2023Q4 | $31.17B |
| 2024Q1 | $30.84B |
| 2024Q2 | $32.41B |
| 2024Q3 | $34.21B |
| 2024Q4 | $35.77B |
| 2025Q1 | $35.13B |
| 2025Q2 | $38.46B |
| 2025Q3 | $39.68B |
| 2025Q4 | $41.46B |
| 2026Q1 | $35.74B |
| 2026Q2 | $38.29B |
| 2026Q3E | $38.93B |
| 2026Q4E | $39.81B |
| 2027Q1E | $37.34B |
| 2027Q2E | $38.74B |
| 2027Q3E | $39.57B |
| 2027Q4E | $40.62B |
| 2028Q1E | $38.23B |
| 2028Q2E | $39.77B |
| 2028Q3E | $40.71B |
| 2028Q4E | $41.87B |
| 2029Q1E | $39.47B |
| 2029Q2E | $41.12B |
| 2029Q3E | $42.14B |
| 2029Q4E | $43.38B |
| 2030Q1E | $40.92B |
| 2030Q2E | $42.66B |
| 2030Q3E | $43.75B |
| 2030Q4E | $45.06B |
| 2031Q1E | $42.52B |
| 2031Q2E | $44.34B |
Assumptions & reasoning
- 4.83% is the guided full-year 2026 operating margin - $6,250M of operating earnings on the $150,500M revenue floor, 4.15% - plus 0.68pp of pro-rata D&A. Terminal 4.95% barely moves, because the move to monthly per-member fees with full PBM and GPO fee transparency and 100% rebate pass-through changes what a script is worth and argues against extrapolating margin expansion here.
- This is the only vertical carrying a seasonality array, and the only one where the shape survives its own noise: revenue factors [0.9635, 0.9950, 1.0106, 1.0309] have an amplitude of 6.7% against window spreads of 1.3-2.3% for Q1-Q3 and 5.0% for Q4, Q1 is the trough and Q4 the peak in every window, and the disclosed script counts corroborate it independently at [0.987, 0.991, 0.994, 1.028].
- Because the driver is unit-based, the engine's deseasonalisation of the basis quarter does not reach it - that step only divides the growth driver's base. The script count entered here is therefore deseasonalised by hand: 387 million divided by the normalised Q2 factor of 0.995.
- Revenue amplitude (6.7%) is larger than script amplitude (4.1%); the excess is fourth-quarter drug mix and cost per script, which is why the seasonal factors sit on revenue while the script trace stays smooth.
- Adjusted scripts are the only volume metric UnitedHealth discloses every quarter on an unbroken basis, and every value in the thirteen-quarter series appears in at least two consecutive releases with the overlaps agreeing.