Quality care is our prescription.
Clinical care is in our DNA. From the very beginning, we’ve always looked for the best ways to provide optimum patient outcomes. That’s why we don’t just fill prescriptions. We constantly evaluate our formulary to match patients with the most effective treatments. If there’s a better—or more practical—prescription option for our clients and members, we tell them. With that transparency comes trust. That’s the WellDyneRx approach.
By offering multiple formularies, we help meet our clients’ diverse needs and stay current in a dynamic marketplace. From minimizing member disruptions to aggressively reducing costs, WellDyneRx formularies reflect our clients’ priorities—keeping costs low and quality of care high.
WellDyneRx is offering three formularies in the 2018 plan year. Additional utilization management strategies can be combined with any of them to augment cost containment efforts.
The Clinical Outcomes formulary is our lowest net cost option, providing the greatest savings opportunity for our clients and members. This formulary limits coverage to medications with clinically meaningful outcomes. Medications that do not offer significant benefits over others in the same therapeutic class are excluded from coverage. New medications are excluded from this formulary until P&T Committee review. We supplement this formulary with multiple utilization management programs, including prior authorizations, quantity limits, hyperinflationary drugs, Generics, and Preferred Brands, to maximize cost containment efforts.
The Clinical Focus formulary is a highly managed drug list which ensures greater affordability for clients and members and helps to reduce overall drug spend. Newly-approved medications are automatically added to this list until they can be evaluated at a P&T Committee meeting. We supplement this formulary with prior authorization, quantity limit, and compound management utilization management programs to maximize cost containment efforts.
The Open Access formulary provides generous coverage for a broad range of medications and treatment options. New FDA-approved medications are automatically added to this formulary until they can be evaluated at a Pharmacy and Therapeutics Committee (P&T) meeting*.
* WellDyneRx uses a Pharmacy and Therapeutics Committee, consisting of independent practicing physicians, nurses and clinical pharmacists, to assist with the development and maintenance of our formularies. The P&T Committee meets on a regular basis to review new and existing medications for inclusion on our formularies.