AlignRx: Founded in 2017, AlignRx advises benefit consultants, employers and health plans on benefits, rebates, plan design and other pharmacy-related matters. ReVision: Founded in 2018, ReVision aims to be a think tank that fosters greater direct communication between health plans and pharmaceutical companies, with a focus on finding new business models that benefit both sides. Penstock: Founded in 2020, Penstock provides payment integrity and auditing services, mainly to health plans.The article outlines how RemedyOne makes the system of drug pricing more efficient.
RemedyOne manages, audits and negotiates drug rebate programs and designs and optimizes drug benefits to help payers (like an employer or health plan) get a better price on medications. The company has been hard at work the past five years winning business from large employer groups, health plans and middle-market PBMs by offering customizable, specialized services, often at a lower price point.The HBJ spoke to RemedyOne client WellFleet about how this approach has worked for them.
Springfield-based WellFleet, one of the largest U.S. administrators of student health plans, has been one beneficiary of Waterbury’s approach. WellFleet, which is owned by Berkshire Hathaway and counts UConn among its 230 university clients, hired RemedyOne four years ago to help it forge a contract with a new PBM and act as WellFleet’s ongoing pharmacy consultant. WellFleet CEO Drew DiGiorgio said it was tough to find the right match, given his company’s college student niche. ‘None of the commercial PBMs were meeting our needs,’ DiGiorgio said. ‘They’re focused on people, on blood pressure medication and cholesterol medications, and there’s a lot of fat on those lines. My college students are on behavioral health medications, contraceptives and specialty drugs.’ With RemedyOne’s help, WellFleet, which uses Cigna’s provider network around the country, built its own private-labeled PBM called WellFleetRx, with a heavier focus on medications college-age patients tend to take. Nearly four dozen of those drugs are offered with no copay charged to the patient. DiGiorgio said the change is saving money for university clients and students. ‘It’s been a win-win all around; we’ve reduced the drug trend,’ he said. ‘We had a negative year last year on drug trend.’ Through its work with RemedyOne, WellFleet has also realized other savings, related to promised discounts or rebates on drug prices. ‘Just because your contract says you’ll get a 65% discount doesn’t mean you’re actually getting it,’ he said. Waterbury’s team determined WellFleet was actually getting something like 62% and confronted the PBM, which quickly made good on the missing (and valuable) 3%. ‘Here’s a million dollars,’ DiGiorgio said.The HBJ also interviewed Goodroot’s new Chief Commercial Officer Erik Wallace. “Wallace joined Goodroot in early October,” the article says, “choosing to leave British medical device maker Smith & Nephew, where he climbed the corporate ladder to vice president of U.S. robotics.” The piece explains how Erik’s “first reaction was doubt” when Goodroot CEO Mike Waterbury outlined the vision of Goodroot for him. However, he quickly came to see how a group of companies each addressing a different problem within the healthcare business presented an enormous opportunity both for the Goodroot companies and the Connecticut business community, as well as his own career. Read the full article here.