Beyond Rebates: Smarter Strategies, Bigger Savings
The traditional PBM playbook is obsolete—prioritizing rebates over real savings and efficiency over appropriate care. At WellDyne, we do things differently. We challenge traditional thinking, focusing on evidence-based clinical solutions, rigorous utilization management, and a relentless commitment to lowest net cost. We don’t follow the pack—we lead by redefining value for our clients and patients.
Formulary Management: Savings Beyond Rebates
High rebates don’t guarantee the lowest net cost. Unlike traditional PBMs that protect their rebate spread, we prioritize first-line therapies and clinically effective alternatives that drive real savings for everyone.
- Promote lower-cost generics and brands.
- Eliminate high-cost, low-value drugs.
- Avoid multi-source brands.
Prior Authorizations: Smarter, Not Stricter
Traditional PBMs often rubberstamp prior authorizations—approving high-cost drugs in the name of convenience and profit. We think a thoughtful no goes a lot further than a mindless yes. By prioritizing clinical appropriateness first and cost-effectiveness second, we prevent waste while ensuring members get the right therapies at the best price.
- Apply strict, evidence-based criteria.
- Prevent off-label utilization.
- Reduce physician appeals.
- Minimize member abrasion with proactive engagement.
Unlike other PBMs, our higher denial rate isn’t a burden, it’s a smart safeguard. In fact, only 16% of denials are appealed, and just 1 in 3 of those appeals are overturned, proving our determinations are clinically appropriate. The bottom line? A well-managed prior authorization isn’t a barrier—it’s a better way to deliver care.
Specialty and Complex Care: Savings Without Sacrifice
Specialty drugs represent the largest share of pharmacy spend—without the right oversight, costs spiral fast. That’s why WellDyne takes a targeted, high-impact approach to specialty management, ensuring better outcomes at a lower cost.
Our WellManaged programs are designed to tackle high-cost therapeutic areas with evidence-based strategies that eliminate waste and improve patient care. Here’s how WellManaged Inflammatory helps control costs:
- Avoid unnecessary dose escalations. When a prescriber increases a patient’s Stelara dose, we use precision medicine to confirm the appropriate therapy—preventing costly, ineffective dose increases.
- Prioritize biosimilar adoption. Even when physicians resist a shift in behavior, we engage them to ensure biosimilars are tried first.
Smart Savings, No Gimmicks
At WellDyne, we don’t play rebate games or approve high-cost drugs without scrutiny. Every decision is backed by clinical evidence, ensuring lower costs and better care.
Clinical savings guarantee—we stand behind our results.
No fine print, no gimmicks—just smarter pharmacy benefits.
Let’s rethink what value really means—because smarter strategies drive real savings and better outcomes.
