Pharmacy benefit manager WellDyne is partnering with Waltz Health to bring greater transparency to its specialty pharmacy clients.
WellDyne is teaming up with Waltz as well as Mark Cuban Cost Plus Drugs as part of its broader member routing strategy, which surfaces real-time alerts and smart prompts that can help its members find the most affordable medication option for them.
The PBM's tech stack also uses automated algorithms to adjudicate claims in the background and let members know when they may be able to achieve savings. The technology optimizes claims across different touch points including retail, home delivery, discount cards and other avenues.
"We wanted to make sure we had the easy and simple tools for the member and the plan to have the access to the product at the lowest cost," Steve Saft, CEO of WellDyne, told Fierce Healthcare.
Rich Wipperfurth, chief commercial officer for WellDyne, said traditional models are also built on simplicity but in a way that steers the member toward preferred distribution channels, pharmacies and other sources.
WellDyne wants to inject more choice back into the equation, Wipperfurth said.
"We're actually taking an opposite approach. We're giving them options," he said. "That patient experience is one that is intuitive, and, ultimately, they get to the right outcome."
"They feel as though they were supported throughout their journey, and, ultimately, they live their life effectively," he said.
In the partnership with Waltz Health, WellDyne will integrate its proprietary Waltz Connect technology to power patient engagement and support around specialty pharmacy. The specialty space is a critical part of drug pricing conundrum and is a key focus for employers and other plan sponsors looking to better manage pharmaceutical spend for their populations.
Waltz's platform uses artificial intelligence to connect patients to the best option for them within its network of specialty pharmacies, which are competing on price to keep costs low.
Jeff Park, president of Waltz Health, said the goal isn't to simply iterate on existing pharmacy benefit management models but to chart a new path for the industry.
"Combining this Waltz AI engine to WellDyne's commitment to transparency and next-generation models is not really a tweak to the PBM business model," Park said. "It's a real evolution of how things are going to happen."
Saft said it's also important for companies like WellDyne and Waltz to make clear to plan sponsors, payers and other stakeholders that there is no "easy button" for solving the challenges in the pharmaceutical supply chain.
"There needs to be organizations that work with integrity and real diligence," he said. "I think this combination really is a representation of that."