Innovative approach to prescription management yields over $15 million in savings
In today’s challenging higher education landscape, controlling healthcare costs while maintaining quality coverage for students remains a top priority for institutions nationwide. Wellfleet is committed to delivering solutions that protect student health and institutional budgets.
Our recent analysis of Wellfleet Rx’s Utilization Management program demonstrates the tangible impact of our strategic approach to prescription drug management. By implementing thoughtful controls that ensure students receive the proper medications at the right time, we’ve generated impressive savings without compromising care quality.
2024 Utilization Management results
Our comprehensive analysis of claims processed between January and December 2024 revealed total plan savings of more than $15 million dollars or $105 per member per year (PMPY). These savings were achieved through three primary utilization management strategies:
Prior Authorization
Our prior authorization process, which ensures medications are prescribed appropriately according to evidence-based guidelines, helped deliver more than $9 million in savings.
Step Therapy
Our step therapy program, which encourages the use of cost-effective medications before moving to more expensive alternatives, helped drive more than $1 million in savings:
Quantity Limits
Strategic quantity limits ensure appropriate medication use while preventing waste. The outcomes typically lead to lower, more appropriate quantities or alternate prescriptions. This part of the program helped drive savings of more than $4.5 million.
Continuous improvement
We’re excited to share that our analysis reveals a steady increase in savings each year! This trend truly highlights our dedication to improving our utilization management strategies. The areas where we’ve seen the most significant impact include treatments for diabetes and weight loss, dermatological care, and psychotherapeutics.
By focusing on these high-impact areas, we can deliver maximum value while ensuring students have access to necessary medications for their health and well-being.
Partner with confidence
Wellfleet’s student-centric approach to pharmacy benefits management delivers measurable value for higher education institutions and their students. Our collaborative approach combines innovative utilization management with dedicated service to create a prescription benefit program that institutions can rely on.
Contact our team today to learn more about how Wellfleet Rx can help your institution achieve similar results.
Resources
1 Wellfleet. (2025, April 15). Wellfleet Rx Student Formulary Outcomes from Utilization Management. 9331 CY24 Member Level Detail & Savings Final 4.4.25. Unpublished, internal 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. ©2025 Wellfleet Group, LLC. All Rights Reserved
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