The Good We Do: Ensuring timely access to HIV PEP medications

Optum clinical pharmacists identified that injured workers needing HIV post-exposure prophylaxis (PEP) faced administrative delays even though the medication must be started within a strict 72-hour window — the transition between workers'-comp claim phases triggered prior-authorization requirements that stalled pharmacy access. The clinical team worked closely with the client to bridge the gap between policy mechanics and the clinical clock. The resulting alignment removed the original administrative barriers, allowing injured workers to receive essential, time-sensitive care without delay. The visible page gives no specific numeric metrics; a downloadable case study offers more detail.

The customer is anonymised in Optum’s own case study — not withheld by us.

Optum is UnitedHealth Group's data and analytics arm, with one of the largest raw claims and EHR-derived real-world-data footprints of any vendor in this directory.

This sits in the Data Providers stage of the AI use-case lifecycle: Named examples from the real-world-data, claims and competitive-intelligence providers pharma AI systems are trained on, benchmarked against, or run inside of.