Wellfleet Rx is a pharmacy benefits solution built specifically for students, taking into account their medical needs, their finances, and their daily lives. Of note, the Wellfleet Rx program boasts 50+ no-cost medications beyond the standard ACA preventative care products.
We sat down with Wellfleet’s Head of Pharmacy, Nicholas Thomas, RPh, PharmD., to get some insight into what makes Wellfleet Rx and the Zero Cost Drugs program so unique.
What is the Wellfleet Rx Zero Cost Drugs program?
‘The Wellfleet Rx Zero Cost Drugs program helps provide medications highly-utilized by the student population at no out-of-pocket costs. Included in this program are products for acne, depression, anxiety, schizophrenia, bipolar, bacterial infections, overdose, and blood sugar monitoring.
These medications and devices have been clinically proven over and over again to be some of the most appropriate options in many scenarios. Also, they have a lower net cost compared to other products that may also be clinically appropriate.’
How is this different from a commercial formulary that other student health plans offer?
‘Wellfleet has over 30 years of experience in the student health space. The Wellfleet Rx Student Formulary and Zero Cost Drugs have emerged from this experience and our dedication to student members. Based on publicly available information in the market today, other health plans can’t say that they have a prescription drug program that is designed 100% for students based on input from student health center clinicians, nor that they offer 50+ drugs at no cost beyond the Affordable Care Act required preventative medications without increasing premiums.’
Does coverage of these medications with no cost sharing increase premium?
‘No increase of premium is necessary for this program. We were very thoughtful about the specific products included in the program, so the program itself leads to decreased plan costs.[1] Offering these products at no cost leads to a higher utilization than non-preferred medications.[2] The cost savings generated by this program allow us to offer it at no chargeleading to lower premiums.’
Are student members forced to use these drugs?
‘Not at all. We still want providers to have autonomy in deciding which medication will be best suited to treat the individual. When cost is a consideration in deciding the appropriate therapy, which it normally is, we empower the member to encourage the provider to consider prescribing one of the medications under this program.’
How do you encourage student members use of Zero Cost Drugs?
‘Members are incentivized to use the Zero Cost Drugs because they are available at no cost to them. In addition, pharmacies receive a pop-up message at the point-of-sale regarding Zero Cost Drug alternatives that are available when appropriate. We also send out monthly educational letters to members and their prescribers who are taking medications with Zero Cost Drug alternatives.’
‘We suggest that the prescriber consider whether the Zero Cost Drug alternative would be appropriate to treat the member’s condition. In our discussions with student health centers, we provide education on the Zero Cost Drugs and can provide files that support prescribing of these medications within the electronic health record system. We try to identify these opportunities as early as possible so that the switch is more likely to happen.’
What’s the catch?
‘No catch! These medications are highly effective and very low cost overall. Providing them at no cost whatsoever to our members helps to increase access to these very important classes of medications. Incentivizing these medications not only gives the members peace of mind that finances won’t be a barrier to their therapy, it helps to control the plans overall spend, and in turn, helps reduce premium increases year over year.’
Facts about Wellfleet Rx
- Wellfleet Rx is a proprietary prescription drug program that is offered directly to Wellfleet Student clients and offers 50+ no-cost medications in key therapeutic classes.
- Wellfleet Rx is supported by a Pharmacy and Therapeutics Committee composed of physicians and pharmacists from a variety of specialties, including student health center providers.
- In the 2023-2024 plan year, 48,000 prescriptions were dispensed through the Zero Cost Drugs program, helping students save over $700,000 in cost-share.3
- In the 2023-2024 plan year, the Wellfleet Rx utilization management programs saved plans over $87 per member, helping to reduce year-over-year premium.4
- Wellfleet has a dedicated Pharmacy team to help answer questions and resolve our members’ issues. In 2024, 97.3% of override requests were resolved within the same day of the request.5
Learn more about Wellfleet Rx Zero Cost Drugs program
To learn more about the Zero Cost Drugs program and how it can benefit you or your institution, visit WellfleetRx.com today and empower yourself with essential healthcare resources.
Disclosures:
1 PrefAlt Avoided Costs Summary, October 2024 ;
2 Preferred Alternative Savings, May 2024 WFRx $0 vs. Non-$0 Comparison, January 2025
3 Reflects Wellfleet Rx book of business, 8/2023 – 7/2024. Wellfleet. (2024, October). Book of Business Claims. Unpublished company document.
4 Reflects Wellfleet Rx book of business, 8/2023 – 7/2024. Wellfleet. (2024, October). Outcomes UM conversions PY 23-24. Unpublished company document
5 Reflects Wellfleet Rx book of business, 1/2024 — 12/2024. Wellfleet. (2025, January). Key Performance Metrics, 2024. Unpublished company document.
Wellfleet, Wellfleet Student, Wellfleet Special Risk, and Wellfleet Workplace are marketing names used to refer to the insurance and administrative operations of Wellfleet Insurance Company, Wellfleet New York Insurance Company, and Wellfleet Group, LLC (known in California only as Wellfleet Group, LLC dba Wellfleet Administrators, LLC). All insurance products are administered or managed by Wellfleet Group, LLC. Product availability is based upon business and/or regulatory approval and may differ among states.
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