May 6th, 2020

WellDyne Speakers at AMCP eLearning Days

WellDyne thought leaders took the virtual stage on April 22 at the AMCP eLearning Days. Jeenal Patel, Formulary Manager and Patty Taddei-Allen, Senior Director, Clinical Analytics, led the educational session, “Evaluating Digital Therapeutics, Drugs and Health Technology for Optimizing Clinical and Financial Outcomes.” In this session, they shared examples and insights into emerging digital therapeutics, utilization management and effective formulary strategies.

Digital therapeutics fall into three categories, to improve a health function, manage a disease or treat a disease. Patty and Jeenal discussed the challenges and opportunities in digital therapeutics, including confusion over whether they should be classified under medical or pharmacy benefits and where they should appear on (or off) the formulary. These and other topics point to the need for increased education for providers, patients and plan sponsors.

WellDyne emphasizes clinically appropriate products within a framework of financial value and savings. As digital therapies and hyperinflationary new drugs come to market, we are evaluating them carefully and increasingly taking steps to keep specific drugs off formulary to better control costs and direct patients to clinically effective therapies.

“Higher specialty drug utilization and unit costs continue to drive overall spending upward in the US market,” Jeenal explained. “These rising costs put pressure on patients, employers and providers.” Strategic formulary removals are a common, industry-wide practice in formulary management today, impacting more than just hyperinflationary drugs. “Me-too” drugs with different ingredients but no added clinical value, brands for which there are generic alternatives, high-cost generics and nonessential drugs that have not been approved by the FDA are also often excluded from the formulary.

The use of exclusions will continue to grow in the future, to promote the most effective drugs while saving money and reducing waste. At WellDyne, we carefully choose to implement high-value exclusions in targeted situations to support positive behavior change in the member population.

The AMCP eLearning Days audience included managed care professionals working in pharmaceutical management, exploring key topics of interest during this unprecedented time of change. In the “posters” segment of the event, WellDyne also shared an analysis of the impact of a pharmacist-led PBM diabetes clinical program on financial and clinical outcomes illustrating WellDyne’s lower costs and improved patient results.