Madeline C. Wallack, CEO, Rx|X Consulting

Madeline C. Wallack

Q: Where did you grow up?

Atchison, KS, best known as the home of Amelia Earhart! 

Q: Where did you go to college/graduate school?

I went to Saint Mary’s College in Notre Dame, IN and graduate school at the University of Minnesota’s College of Pharmacy for my PhD in Social and Administrative Pharmacy. Absolutely loved both experiences but it is hard to top Notre Dame football!

Q: What are your favorites?

Food: I love food and am in the “live to eat” camp! My favorite food is Italian and my go-to is Spaghetti with Frutti de Mare and spicy arrabbiata sauce. The spicier the better!

Movie: I could say something intellectual, but the truth is Legally Blonde.  When I need to be comforted, I go for anything starring Reese or Drew. I save my more cerebral preferences for books!

Musicians:  I grew up singing and was in choir through college so this is a tough one. I love everything from classic rock to rap but if I have to choose a few, I will go with Beyonce, The Cure (I was a moody teen), and Fleetwood Mac. 

Destination: Dublin—the Irish are the absolute best and the city has incredible energy. 

Q: What do you like to do outside of work?

Outside of work, I love traveling and cooking. I put together city guides for all of my friends so reach out if you are looking for recommendations!  Little known fact: I am also a makeup pro and for many years had a successful side business doing weddings (including most of my former OIG coworkers!), fashion shows and shoots. Another fun outside interest of mine is health and wellness. In 2019, I completed the Institute for Integrative Nutrition’s certified holistic health coaching program for my own personal development but learned so much. 

Q: What kind of work does your company do in 340B and what makes it stand out?

Rx|X has been offering the full suite of 340B services including comprehensive program evaluations, contract pharmacy audits, risk assessments, financial reviews, and policy forecasting since 2013.  Our goal is to have quality engagement with covered entities that are invested in their programs’ staff and skillsets and are forward thinking about operations and program design.

I think that Rx|X stands out for three reasons. First, the dynamic between my partner, Suzanne Herzog, and me is the result of working together for the entirety of our careers and is at the core of our many successful projects.  Each of us brings complimentary skills and expertise that give our clients a senior level team capable of presenting issues and solutions in a multitude of ways. We really “riff” off each other!  Second, because our background and training is in program evaluation, we are creative problem-solvers. We think about qualitative and quantitative data in novel ways to get you clear options and conclusions. Finally, we have lived through 22+ years of 340B history in different roles with the government, HRSA sub-contractors and as the founders of Rx|X.  We are part of the OGs of 340B! 

Q: Why did you choose to work in the 340B space?

Working in the 340B space started as luck but evolved into my passion! My first job out of college was as an analyst for the Office of Inspector General and my first assignment was to analyze how ADAPs utilized 340B. This was 1999 and the government was wondering why the program was so underutilized! Becoming proficient in the challenging topics of 340B and Medicaid was such a big investment that my boss thought it was best if I stuck with it. Ready or not, I became the Agency’s 340B expert and dove in head first to learn all I could through conferences and building relationships with others in the industry. I could have never imagined that this program would grow into what it is today and feel fortunate to not only understand the history but also have so many fantastic relationships.  

Q: What do you feel is your most significant contribution to the 340B world or to a 340B customer/client?

My most significant contributions to the industry are the handful of OIG Reports I led that helped to shape the 340B program from 2010 on. In particular, I am proud of the 2006 report on Manufacturer overcharges and the subsequent role as an expert witness for the Santa Clara v Astra case related to this issue. Although the case was dismissed by the Supreme Court due to administrative issues, it was such an incredible experience and it continues to influence cases today. 

As far as significant contributions to clients goes, we have had some sizable wins in overturning HRSA audit findings and pushing back on manufacturers, but our greatest successes are when we share advice that we know is alleviating stress of the unknown. 

Q: What advice do you have for a young professional who has recently launched a career in the 340B space?

I would tell them to pay equal attention to 340B policy and operations and know that no two entities look the same.  Oh, and invest in becoming an Excel Wizard!


For questions, Madeline can be reached at mwallack@rxxconsulting.com.

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