Brenda Cheung, SVP of Clinical Innovation at WithMe Health, has more than 15 years of experience in leading clinical strategy and operations. She previously served as Chief Pharmacy Officer at Burd Health, a healthcare solutions company where she was instrumental in helping employers reduce healthcare costs and improve outcomes. Earlier in her career, she held several leadership roles at Kaiser Permanente overseeing retail and hospital pharmacies, clinical programs and utilization management. Brenda received her Doctor of Pharmacy degree from Massachusetts College of Pharmacy and Health Sciences and her MBA from the Wharton School of the University of Pennsylvania. 

The Pulse: Can you speak to your career trajectory and what brought you to WithMe?

Brenda Cheung:

Digital health has become a really exciting space in the last few years, with the emphasis on value-based care leading to the generation of new ideas and innovation in healthcare

I’m a pharmacist by training, so my career path is a bit traditional with some non-traditional components. After becoming a clinical pharmacist, I took part in Kaiser’s EMR clinical content and process development. At the time, EPIC was much smaller, and they were an early collaborator with Kaiser to build and modernize medical charts. Little did we know how massive a journey that would be – this experience taught me so much about the potential in digital health innovations. From then onwards, I took part in the development of population management, care management and clinical program management at Kaiser, which has a more integrated model than what’s standard in the US. I then moved into pharmacy operations to oversee retail pharmacies, hospital pharmacies, infusion clinics, as well as manage overall drug spend for my territory. However, I realized most of the US health care delivery systems do not operate with as much cohesiveness as Kaiser, and I began looking for more ways to understand healthcare fragmentation and the diversity of stakeholders. I soon found myself in the employer-sponsored health plan space, helping self-insured employers reduce their health care costs.

Ultimately, this is where I got more interested in actually impacting the ways we can drive value in healthcare by aligning incentives for employers and health plans who pay for their employee and plan participants’ health benefits, as well as for consumers who use their prescription benefits (our members). That experience led me to WithMe Health, where we seek to increase healthcare transparency, and provide objective guidance to our members. We’re able to manage their medications and optimize clinical outcomes, all while reducing healthcare costs.

The Pulse: At a high level, what would you say are WithMe Health’s main services and product offerings?

BC: WithMe Health is a series B start-up, founded to provide outcome-driven medication guidance service for our members. We are also a PBM. We are looking to disrupt the PBM (Pharmacy Benefits Manager) space by both providing transparency around medications and aligning incentives for medication therapy. So much about how traditional PBMs function and how they bring revenue is by taking a spread from undisclosed amounts drug rebates and discounts, providing more medications simply means more revenue, regardless of drugs’ appropriateness or cost effectiveness. Their incentive isn’t really aligned with the end result of improving a member’s health outcomes. As a fully passed-through PBM, we only charge employers an admin fee for our service, passing all discounts and rebates we receive for drug contracts on to the employer who pays for the pharmacy benefit. This makes us very different from traditional PBMs and aligns our incentives with the goal of simply getting our members to be healthy. Our revenue is not tied to the amount of prescriptions dispensed.

The Pulse: I’d love to learn more about your Medication Guidance offering specifically.

BC: With Medication Guidance, we start by reviewing all the medications a member takes – their “whole medicine cabinet”. We use evidenced-based approaches to assess if the drug is appropriate for the member’s condition. We also help them resolve any barriers to getting and staying on the drug, make sure they are taking it appropriately, and ensure the drug is working as expected and without side effects, etc. If we’re able to identify a different alternative, that’s actually better value or providing a better outcome, we will reach out to the member’s providers to determine if a switch is appropriate.

We want to put that member in the center, meet them where they are, and be the long-term trusting partner in managing their conditions or whatever medication therapy needs they have. That’s what Medication Guidance is about, which is very much needed and different from the current day pharmacy experience. Healthcare can feel like such a fragmented experience. When you’re at the provider’s office or pharmacy, you’re likely in and out in 15 minutes and don’t always have the time or know-how to follow-up on your treatment plans, your goals, if there are other treatment options, the best priced one for your plans. We’re seeking to change that.

The Pulse: Can you talk about how you’re leveraging technology to empower your consumers?

BC: Our clients are generally employers, and we focus our services on taking the best care we can of their members. That focus will ultimately bring the best value for our clients who are paying for the members’ healthcare expenses. When we are designing the services that we’re providing, ultimately it must be with aligned incentives, transparency, and bring the best value and outcomes for our clients and members.

We are a different type of PBM, not only transparency-wise, but also in leveraging technology through our streamlined member-facing mobile app to provide best-in-class services to elevate the level of functions that we can provide. Nowadays, consumers are very different – not everybody wants to be engaged in the same ways nor do they want to interact with information and providers the same way. And therefore, we really look at a multi-channel communications approach in terms of how we can engage members on their own healthcare journey based on their individual preferences.

The Pulse: What outcomes is WithMe looking at when it comes to your two product offerings: the full service PBM vs. medication guidance? What are some of your metrics of success?

BC: Medication adherence is a key metric. We strive to increase adherence by helping members break down the barriers on why they’re not taking medications as prescribed. We also look at clinical, quality and financial outcomes associated with different disease states. If somebody is on the appropriate treatment, and being managed well, they will have favorable overall outcomes: decreased hospital stays, decreased visits, better biometrics in measurables like blood pressure, decreased risk for mortality or complications, reduced organ damage, things like that. I would say a lot of the metrics fall under these outcomes that can be tied to appropriate management of their medication therapy, as well as increased adherence.

The Pulse: Would you be able to speak to the validation for savings achievement that WithMe hit earlier this year?

BC: In addition to looking at providing transparency and supporting great customer service, we also want to make sure that through the model, our clients are getting the savings that they’re looking for. The Validation Institute is a third-party institute that comes in and validates claims. We received external validation on the claims that we have processed confirming the fact that we are indeed providing a significant reduction in cost to our clients. That carries substantial weight and objectivity to our claims on cost reduction and ROI.

The Pulse: Any advice you have from your time at Wharton, or that you’ve learned in your career to date?

BC: I really enjoyed my time in Wharton. It challenged me in a way that I would not otherwise be challenged staying in my own vertical. Because of the diversity of industry backgrounds my classmates brought and the different perspectives everybody shared, it makes you understand the complexity of business beyond the stage and type of company that you’re working in. It’s such a rich environment that opens you up to so much more than you’d expect. I know some of us are very goal-oriented and have an idea of what we want to be coming out of Wharton. But I’d say to keep an open mind as to what we can learn from fellow classmates, professors, people in our network, and the extent to which we can borrow those learnings and use it in our own career journey or in our own business functions. Obviously, network and get to know others, but make sure to keep an open mind.

Interviewed by Kavya Bodapati, December 2022.

—

On Feb 16-17, 2023, Wharton is excited to feature more expert perspectives at our annual Wharton Health Care Business Conference. This year’s theme is ‘The Empowered Health Care Consumer’. Conference details and early-bird tickets are available here.