Q&A: The New Technology Platform Revolutionizing How Pharmacy Benefits Are Managed

Through the use of well-established and revolutionary technology using artificial intelligence (AI) and machine learning, Bill Wolfe, COO of WriteWise, and his team are making accountability and transparency the focus for patients and payers around the country. With so much ongoing regarding pharmacy benefits and how pharmacy benefit managers (PBMs) operate in the marketplace, the team at WriteWise is providing yet another innovative way to save patients money and improve their health outcomes.

“The main problem is to create accountability and alignment between the PBM, the client, and the member,” Wolfe told us. “The way that we are doing that is by using a technology platform called MavRx that is really at, what I like to say, the intersection of actuarial science, AI and machine learning, and deep-domain PBM expertise.”

In part 3 of our interview with Bill Wolfe, he explored the MavRx platform and how its thoroughly developed technology is helping its partners get ahead of what they may need to spend on in the future. With such a significant opportunity to improve the distribution of pharmacy benefits in the US—whether through grassroots PBM movements or products like MavRx—we caught up with Wolfe to truly understand the current state of the pharmacy benefits industry.

Above all else, Wolfe harped on the importance of accountability within the pharmacy benefits landscape.

“It is not sustainable to continue to have costs go up and up and up, have employers pay more, have members pay more, and not really be able to demonstrate outcomes at the same time,” he continued. “What accountability does is really creates that alignment and a framework for how we use pharmacy benefits”

Wolfe explored the MavRx platform and how its thoroughly developed technology is helping patients, providers, payers, and employers alike. | image credit: peopleimages.com / stock.adobe.com

Read through part 3 of our interview with Wolfe and be sure to tune into our full-length conversation with him, which will be releasing on Over the Counter podcasting channels this coming Wednesday afternoon.

READ MORE: How Pharmacy is at the Forefront of an Evolving Prescription Benefits Landscape

Drug Topics: What is the main problem you and your team at WriteWise are trying to solve and how are you going about solving it?

Bill Wolfe: The main problem is to create accountability and alignment between the PBM, and the client, and the member, obviously. The way that we are doing that is by using a technology platform called MavRx that is really at, what I like to say, the intersection of actuarial science, AI and machine learning, and deep-domain PBM expertise.

[The platform ingests] claims premised on a database we have today of 100 million claims and growing, and 8 million claimants, to create predictive modeling that allows for, what I call, killing the spreadsheet. What I mean by that is our tool tells you what you're going to spend next year with a certain degree of accuracy that we at WriteWise are willing to back relative to helping PBMs guarantee cost at a per member per month (PMPM) level. [It’s] not just that discounted rebate but what is the trend going to be? By doing that, we create this alignment with the client that says, with our PBM partners, you're going to get cost certainty. You're not just going to get discounts on paper that don't result in knowing what you're actually going to spend on your pharmacy benefit.

Drug Topics: What is the importance of accountability in the greater health care industry in the US—a system that has often been criticized for its lack of accountability and transparency?

Bill Wolfe: The overarching importance is that the rubber has finally hit the road. What we are doing is not sustainable, whether it's on the medical side or, in particularly, on the pharmacy side. It is not sustainable to continue to have costs go up and up and up, have employers pay more, have members pay more, and not really be able to demonstrate outcomes at the same time. What accountability does is really creates that alignment and a framework for how we use pharmacy benefits—and this is my opinion—most efficiently to create outcomes for members and reduce overall health care costs by making people healthier through the efficient use of drugs.

Our tool helps create that alignment, because of the fact that striving towards that guarantee of a PMPM spend predictability, and holding the PBM accountable for reaching that, sets up a situation where, even as an employer or as a consultant, deciding on pharmacy benefit, you meet your fiduciary duty as well if you've gone through the process, not just of running spreadsheets and what would I have saved, but what will I spend. We're really at that point of the time to stop pointing fingers and to really create this framework. We know how the benefit can be managed. We know what the cost components are. Now, we're going to partner the PBM with the client and with the members.

READ MORE: Q&A: Transparent, Pass-Through PBMs Gaining Traction Over Big 3

Pharmacy practice is always changing. Stay ahead of the curve: Sign up for our free Drug Topics newsletter and get the latest drug information, industry trends, and patient care tips, straight to your inbox.