WisconsinRx Prescription Drug Purchasing Cooperative

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

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