Wellfleet Rx – Proving its value

Wellfleet is committed to foster engaged and educated consumers of healthcare and our exclusive student pharmacy solution is helping to do just that - and save money. Early results on overall savings from the first half of this school plan year (August 1- December 31, 2019), are impressive.

Wellfleet Rx is our exclusive student pharmacy solution developed for the college health space that aligns with students’ budgets, schedules, and lives, and features the world’s first formulary designed for Student Health.

Early results on overall savings from the first half of this school plan year (August 1- December 31, 2019), are impressive. With 7.2 percent of all prescriptions falling under our $0 copay, students have saved more than $23,000! Further, in December almost 88 percent of prescriptions were being filled with quality generic medications.

What’s behind Wellfleet Rx?

Wellfleet Rx helps improve the pharmacy experience for our student members and includes in-depth clinical programs to ensure they receive only the most appropriate and cost-effective prescriptions for their conditions. Further, our exclusive formulary provides students with more than 40 generic medication options with a $0 copay to drive utilization to preferred medications and improve access within the drug classes they need most.

Wellfleet Rx savings

We’re committed to foster engaged and educated consumers of healthcare. In addition to working with student health centers, in the first half of this plan year, we sent 1,818 letters to members and prescribers on the benefits of converting to $0 and lower-cost generic options. By empowering our students to know their options at the point of prescription, we can help them save. In fact, we found that 4,632, $0 copay prescriptions have been filled – leading to $23,735 in member savings!

The utilization management programs, including prior authorization, step therapy, and quantity limits, offered through Wellfleet Rx generated $1.91 per member per month in plan savings in the 2018-2019 plan year.

Compared to pricing under other PBMs in June 2019, we found that Wellfleet Rx generates savings on several drugs highly utilized by the student population; these drugs include Stelara (3%), Humira Pen (8%), Lo Loestrin FE (23%), and Vyvanse (8%).

Key findings

In our analysis, we dove deep into two long-standing member groups with 10,000 and 25,000 members, respectively, that transitioned to Wellfleet Rx this plan year to identify trends. We found the following factors are helping to reduce overall member costs:

  • Moving to the Wellfleet Rx Student Formulary improved generic utilization by at least 2 percent
    • 87.5 percent to 89.7 percent of prescriptions are being filled with quality generic medications
  • We estimate a net cost/Rx savings on up to 28 of the 50 top drugs utilized both plan years.
    • The average savings of $280 per prescription is driven by improved discounts and rebates!
  • Through more effective step therapy requirements, medications that were unmanaged under the prior formulary are substituted for more cost-effective, appropriate alternatives, reducing utilization of higher-cost drugs.
  • Prior high-cost drugs with lower-cost alternatives are excluded, steering members to quality, cost-effective options.
  • We’ve seen an overall gross ingredient cost/Rx savings of up to 5.7 percent.

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Wellfleet is the marketing name used to refer to the insurance and administrative operations of Wellfleet Insurance Company, Wellfleet New York Insurance Company, and Wellfleet Group, LLC. All insurance products are administered or managed by Wellfleet Group, LLC. Product availability is based upon business and/or regulatory approval and may differ among companies.