The Wellfleet clinical team continuously evaluates the pharmaceutical landscape and the latest clinical and financial information for impact on its proprietary Wellfleet Rx Student Formulary and $0 copay options under the formulary to ensure we’re providing student members with the best options to meet their prescription drug needs.
As a result of this process, we released a January 2022 update to the Student Formulary that helps manage costs, while ensuring efficacy and access to highly-utilized classes of medications.
Adding Fluoxetine, Lithium and other quality medications to the $0 copay drug list
As of January 1, positive updates were made to the Wellfleet Rx Student Formulary that include modifications to drug tiering and utilization management requirements.
Some notable updates were those made to the $0 copay drug list, many of which help reduce member and plan costs, while ensuring access to highly-utilized medications. Here are some noteworthy updates that help illustrate the modifications made to the $0 copay options effective at the start of 2022; noted in the chart below.
Fluoxetine, is the generic equivalent of Prozac, Sarafem, or Rapiflux and is utilized for the treatment of disorders such as major depressive disorder, OCD, panic disorder, premenstrual dysphoric disorder, and bipolar disorder.
“Previously, paroxetine was included as a $0 copay option to treat those disorders, but in further review of clinical data when compared to paroxetine, fluoxetine showed better efficacy and less adverse side effects in the age group we serve,” noted Jennifer Stevens, Wellfleet’s Director of Clinical Programs.
For example, fluoxetine is less likely to cause dry mouth, constipation, weight gain, drowsiness, and muscle pain when compared to paroxetine. Further, it is more commonly provided as a first-line therapy (initial therapy option recommended by the FDA) to treat the aforementioned disorders.
“What made this decision even better is that fluoxetine is also the only FDA-approved medication on the market to help with bulimia nervosa. It has been proven to reduce binge-purging cycles for patients utilizing it, while also helping with depression and anxiety that may go along with an associated eating disorder.2 Further, by providing fluoxetine at a $0 copay, we’re hoping to improve access to this necessary medication for student members with this eating disorder,” Stevens added.
Lithium is a drug that is commonly used to treat mania related to bipolar disorder, as well as to reduce the frequency and severity of manic episodes.3
Upon clinical review of medication utilization among our student population, we found this to be a drug that was frequently prescribed as a first-line therapy for schizophrenia and bipolar disorder.4
“Given its high efficacy, ability to be used with other antidepressants or mood stabilizers as dual therapy, and lower cost, it was an easy decision to add to the $0 copay drug list,” said Stevens.
Finally, we examined prescription trends for our student population to identify ways to improve the overall experience.
The data revealed a subsection of student members who received increases in dosage of their medications to improve their treatment, which unfortunately caused their copay to increase. This didn’t sit well with us.
We strongly believe that student members shouldn’t be charged a higher copay for an increase of the same medication that is helping them. So, to create a better experience and reduce out of pocket expenses, we added additional strengths of olanzapine, quetiapine, sertraline, and citalopram to the $0 copay drug list.
We’re committed to providing the best experience for our student members. That’s why we continuously review all our clinical programs.
To learn more about Wellfleet Rx and the 40+ drugs and devices available to Wellfleet Student members at no cost, visit https://wellfleetstudent.com/wellfleet-rx/.
1Zero Cost Drugs program may vary by school or may not be available to certain schools. See applicable Student Formulary for more details. If there is no “Zero Cost Drugs” section included in the Student Formulary applicable to your plan, this program is unavailable.
2 Montecatini. (n.d.). Eating disorders are a classified mental illness. People suffering from this disease not only struggle with under and over eating, but also with anxiety and depression. Retrieved on January 6, from https://www.montecatinieatingdisorder.com/eating-disorders/articles/antidepressants-and-ed/#:~:text=Prozac%20has%20proven%20to%20reduce,brain%20chemicals%20that%20control%20mood.
3 MayoClinic.(n.d.). Lithium. Retrieved on January 5, 2022, from https://www.mayoclinic.org/drugs-supplements/lithium-oral-route/side-effects/drg-20064603?p=1)
4 Dea, Lauren, Tran, James. (2016, November 17). Management of bipolar disorder. https://www.uspharmacist.com/article/management-of-bipolar-disorder