What we do

WMC enables Health Plans to lower pharmacy benefit costs! We help clients understand their present pharmacy benefits and how they can be better managed. We typically find that the current Pharmacy Benefit Manager (PBM) has executed a one-sided Agreement that allows it to:

  • Charge too much;
  • Hide much of its profit behind an opaque business model;
  • Skew the benefit design and management to enrich themselves at the expense of both the Plan and Recipients

Our process – at nominal cost --begins with an analysis of the present PBM relationship and includes:

  • Educating the plan sponsor on the intricacies of pharmacy benefit management;
  • Careful review of the current PBM agreement and the vendor's performance;
  • Review of pharmacy benefit design.

We then move on to renegotiation with present vendors, or the recruitment of replacements.
Unlike many large consulting firms, WMC looks solely to its clients for compensation. Our fees compare very favorably to those of the large health care benefit firms and all services are provided by staff with decades of pharmacy and health care experience.

PUBLIC HEALTH SERVICE (PHS) Drug Pricing (340B)

The Veterans Health Act of 1992 created a special drug pricing arrangement for certain qualifying entities, basically the health care safety net providers. As defined under Section 340B of the Public Health Services Act, these entities can, under specifically described circumstances, buy drugs at discounts that average 60% below the Average Wholesale Price (AWP). Qualified entities include:

  • Disproportionate Share Hospitals
  • AIDS clinics
  • Community Health Centers
  • Others

The rules governing access to 340B pricing are so complex that many qualified entities fail to take advantage of this very valuable federal program, but WMC has the knowledge and experience to help our clients access these lower costs and improve both drug access and affordability.

Mike Winkelman

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