Congressional panel probing claims of ‘opaque business practices’ at Irish arm of UnitedHealth Group
US congressman James Comer, a Kentucky Republican, who chairs the committee, has written to Dr Patrick Conway, the CEO of UnitedHealth’s Optum RX subsidiary. In the letter sent last week, the Congressman – a close ally of President Donald Trump – has claimed the Irish company is using a pharmaceutical purchasing organisation that it has established here as a way “to evade transparency and oversight in the United States” to the detriment of American patients.
Comer has demanded a series of company documents and information about the Irish-based entity.
Optum employs almost 1,600 people at offices in Dublin and Letterkenny, Co Donegal.
UnitedHealth Group tragically hit the headlines in December 2024 when its CEO Brian Thompson was shot dead in New York last December.
The company was already the focus of the Comer-led Congressional committee since July 2024 when Republicans on the committee released a report entitled, The Role of Pharmacy Benefit Managers in Prescription Drug Markets. That report made detailed allegations that pharmacy benefit managers (PBMs) used their position as middlemen to enact anti-competitive policies and protect their bottom line.
The congressional committee is now seeking specific information about a PBM that the UnitedHealth subsidiary has set up in Ireland.
PBMs are third-party companies that act as middlemen between health insurers, drug manufacturers, and pharmacies. Their main purpose is to manage prescription drug benefits for health plans established by large employers, insurance companies, and US government programs like Medicare.
In his letter to Conway, Comer states that Optum’s Irish headquartered PBM – Emisar Pharma Services, LLC – was set up “to evade transparency and oversight in the United States”.
“This is especially true for GPOs headquartered overseas as these entities may be used to retain additional revenue and fees and to sidestep US legislative and regulatory reforms.
“Emisar Pharma, which UnitedHealth Group’s Optum Rx created in 2021 and is headquartered in Ireland, appears to be yet another example of the institutional intent at opacity and avoidance of oversight within your company,” wrote Comer.
In April, Trump signed an executive order that “required PBMs to disclose the fees they pay to brokers for enrolling employers in PBMs” and the Federal Trade Commission has resumed lawsuits in this regard.
“The Committee is concerned that your company’s opaque business practices and relationships, including the creation of new corporate structures abroad, combined with unchecked integration, is hurting patients and costing taxpayers,” he wrote.
The Congressman requested documents and communications regarding the creation and role of Emisar Pharma.
“Emisar is based in the US, and we have employees in both the US and Ireland,” said Elizabeth Hoff, a spokeswoman for Optum RX. Our Dublin-based team is an important part of Emisar’s ongoing efforts to provide significant value for participating members, health plans, and consumers. We look forward to responding to the congressional committee’s letter.”