Transcript WisconsinRx: Prescription Drug Purchasing

WisconsinRx
Prescription Drug Purchasing
Cooperative
www.wisrx.com
Faced with escalating prescription drug costs,
a coalition of private health care buyer groups
collaborated to create the not-for-profit
Wisconsin Prescription Drug Purchasing
Cooperative called:
WisconsinRx
Background
• WisconsinRx is a statewide purchasing
cooperative, run by the private sector, designed to
bring state businesses together to purchase
prescription drugs in volume
• The Alliance, the Fond du Lac Area Businesses on
Health (FABOH) and the WEA Trust came
together to create this system of purchasing drugs
WisconsinRx goals
• Volume discounts
– Strength in membership equals enormous
purchasing power
• Honest pricing
– Complete transparency. No hidden costs.
• Evidence-based medicine
– Independent Wisconsin-based physicians and
pharmacists to determine the right drugs at the
right price
WisconsinRx goals (continued)
• Customer service
– Excellent service
– Access to a comprehensive pharmacy network
– Education and information for employers and
employees
• Your watchdog
– Protecting your financial interests
– PBM oversight, audits, and reports
The process
• 12 PBMs bid to administer Rx claims for
WisconsinRx
• An independent consultant assisted in the review
of these bids
• Five finalists were invited to make presentations
before a screening and review committee; and Rx
claim repricing analysis
• Founding members then selected the top two
PBMs for further negotiations AdvancePCS was
chosen to provide PBM services
Why AdvancePCS?
• An experienced national PBM able to administer
multiple benefit designs for varied WisconsinRx
member groups
• Sophisticated systems capability and access to a
broad range of clinical resources
• Excellent pricing terms for WisconsinRx
• Committed to transparency of pricing
• Willing to support a Wisconsin-developed formulary
• Will establish a service center in Wisconsin
Membership categories
• Founding members
– The Alliance, FABOH, and WEA Trust
• Affiliate members
– Associations, coalitions, and other groups that
join primarily to support the coop and to
promote WisconsinRx
• Participating members
– Employers or insurers that hold all or some of
the risk for prescription drug cost
Benefits of Membership
• Access to favorable drug prices including guaranteed
discounts levels on brand and generic drugs and
guaranteed rebates
• Use of a WI evidence-based preferred drug list
• Low administrative costs
• An honest deal with no hidden costs
• Pharmacist consulting
• Protections built into the master PBM agreement
• Watchdog function – contract monitoring and auditing
• Continuing education on cost-effective use of medications
• WisconsinRx Users Group to discuss current drug benefit
issues
How can I become a Participating
Member?
• Sign nondisclosure form to review specifics of WisRx
contract terms with AdvancePCS
• Review terms of agreement utilizing your agent and TPA
(as applicable); conduct a Claims analysis, if needed
• Join WisconsinRx by
– signing a new member agreement;
– paying a one-time application and per covered life fee
(application fee waived for Alliance/FABOH members);
– and an ongoing per member per month fee
Visit www.wisrx.com
How to become a Participating
Member (continued)
• Implementation phase
– Select plan options, formulary, copays,
coinsurances
– Sign addendum to master contract held by
WisconsinRx
– Mail service history transfer (if applicable)
• Roll out to employees
– ID cards, benefit communications