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Blue @ Work

Delivering the lowest net-spend

Drug costs are on the rise

Reality: Drug costs are on the rise.

Solution: Wellmark Blue Cross and Blue Shield’s pharmacy program.

Through our pharmacy program, you and your employees can expect best-in-value benefits, while being paired with appropriate, cost-effective medications that improve health outcomes and overall costs.

By integrating these four components into one powerful pharmacy benefit program, rest assured that we will deliver the lowest net-spend for the health of you and your employees.

The power of four.

Our unique management strategy works to deliver the right formulary for the right reason and at the right time for your employees — without sacrificing your bottom line.

Formulary management.

The experts of Wellmark's Blue Cross and Blue Shield's Pharmacy and Therapeutics (P&T) Committee Opens in a new window decide what prescription drugs and devices make the Drug List. This committee is dedicated to regularly review drug formularies to ensure safety, effectiveness and value.

Generic dispensing rate.

The design of the Wellmark Drug List encourages generic use, which results in industry-leading dispense rates and an overall lower net-cost.

Utilization management.

Various benefit designs and clinical programs to be used to encourage doctors and your employees to use lower-cost drugs without worrying about lack of effectiveness. Wellmark bases utilization management Opens in a new window on expert inputs from the Pharmacy & Therapeutics (P&T) Committee, recommendations from our pharmacy benefit-manager and guidelines issued by state and federal agencies.

Specialty drug management.

With new drugs entering the market daily, expert management is important for protecting your health care and pharmacy budget. We use these three components to manage the rising cost of specialty drugs:

  • Make sure drugs are covered under Rx Specialty with copay.
  • Provide access to two preferred vendors only.
  • Implement value-based design using preferred/non-preferred drug lists.

Our specialty drug strategy appropriately places drugs under medical and pharmacy benefits to help your employees better manage specialty drug use and their budgets.

Questions about Wellmark’s pharmacy benefit program? Contact your Wellmark representative for more information.