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ARTICLE Diversion/Forgery Controls Pilot

Pharmaceutical diversion (using prescription drugs for recreational purposes) and counterfeiting are growing problems in the U.S. In 2009 $186 million dollars in stolen pharmaceuticals ended up on the streets for recreational use, double what was reported in the previous year.1


Last year our OptumRx business segment released a new administrative support system called the Integrated Rx Information System, or IRIS. IRIS supports our mail order pharmacies and call centers for ordering, billing and inventory.


Now OptumRx is exploring new ways to integrate diversion and forgery flags into IRIS. The Diversion/Forgery Controls Project is dedicated to proactively recognizing diversion and forgery risks – before fulfillment.


We want IRIS to provide a real-time ability to monitor and identify cases of diversion/forgery for the specific, high profile drugs identified in the program. OptumRx is also developing additional reporting capabilities to allow ongoing monitoring of suspicious activity.


IRIS and the Diversion/Forgery Controls Project, is an example of an innovative, highly customized system designed to ensure drug safety and cost savings. In addition, it should result in improved service and ensure that members waiting for their medications will not have unforeseen delays.


  1. Pharmaceutical Crime: Investigating and Prosecuting Drug Diversion and Counterfeiting Institute of Health Law Studies. March 25, 2010