Our model is flexible. We can replace your PBM or provide Medication Guidance on top of your existing PBM.
You face many options. Let’s help make sense of it all. Here’s how our Modern PBM and Medication Guidance solutions compare to those options.
If so, our full replacement modern PBM solution is right for you.
Our unique Medication Guidance is included in our PBM offering. No piecemealing, no buy-ups.
If so, we can still help in a meaningful way by overlaying our Medication Guidance solution on top of your existing PBM. We’ll get the right data from them and engage your members in ways they won’t.
|Features||Personalized Medication Guidance||Modern PBM|
|Member mobile app||○||○|
|Guide app (purpose-built CRM)||○||○|
|Configurable clinical rules engine||○||○|
|Pharmacist-led guide team||○||○|
|Customizable clinical programs||○||○|
|Enhanced guidance scope & impact||○|
|Formulary and plan design management||○|
|Pharmacy network and drug pricing||○|
|Big 3 PBMs||Other Independent PBMs||Retail Savings Solutions||Specialty Carve-outs|
Compare to WithMe Health's Modern PBM
|Core PBM (e.g., claims processing)||Yes||Yes||Yes|
|Rates||Competitive||Lowest for Jumbos||Competitive|
|Rebates (pass-through or not)||True pass-through||Keeps some rebates||Pass-through varies|
|Administrative fee||Fixed, PMPM only||Varies, extra fees||Fixed, PMPM only|
Compare to WithMe Health's Personalized Medication Guidance
|Pharmacist-led medication guides||Yes||No||No||No||No|
|Clinical Rx programs||Fully Integrated||Separate, buy-ups||Separate, buy-ups||Limited||Specialty only|
|Guidance support scope||Specialty & Retail||Limited||Limited||Retail focus||Specialty only|
|Proactive outbound interventions||Guide-driven||No||No||Mainly self-service||No|
|Digital Rx experience for members||Core experience||Core experience||Limited||Core experience||Limited|
|Personalized savings opportunities||Yes||No||No||Yes||Yes|
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