posted 01/02/03
A new diabetes program
set to roll out with specially trained pharmacists.
Five nationally known
companies will roll out a diabetes program in 2003 modeled after a successful
initiative in Asheville, North Carolina, where specially trained pharmacists
have played an instrumental role in helping the city avoid millions in
disease-related costs.
The American Pharmaceutical Association's (APhA's)
research and educational arm is orchestrating the national pilot with an
educational grant from the pharmaceutical giant Aventis.
The project is the first to try to replicate the
Asheville model on a national "scaleable" level, said Dan Garrett, the program's
project leader. At least 500 diabetic employees are expected to participate
across the five as-yet-undisclosed pilot sites, which include several Fortune
500 companies.
"What we're trying to do is figure out how to
ramp this up so it can go nationwide," said Garrett, the APhA Foundation's
senior director for medication adherence.
Aventis, maker of the long-acting diabetes
treatment Lantus (insulin glargine), has not disclosed the amount of the grant.
Melissa Feltmann, a spokeswoman for the drugmaker's Bridgewater, New
Jersey-based pharmaceuticals unit, said Aventis sees this program as an
opportunity to help patients achieve better control of their blood-glucose
levels.
More than half of all Americans with diabetes
fail to keep to keep their blood sugar in check, she said, a problem that is
costing the nation billions in healthcare-related expenditures and lost
productivity on the job.
Employers involved in the "patient
self-management" program hope to slash those costs and improve the health of
their workforce by following Asheville's lead. And if the experiment works, it
will help bolster the pharmaceutical industry's argument that appropriate use
and management of medications saves the healthcare system money and results in
better outcomes.
About six years ago, the city of Asheville
embarked on a unique solution to lower medical costs, linking diabetic workers
to pharmacists trained in managing the disease. Pharmacists are paid a fee to
"coach" patients on diet, exercise and medications, provide foot exams, review
glucose-monitor readings and consult with doctors.
It's voluntary program, but Asheville achieves
significant compliance by offering to waive the co-payments on disease-specific
items, such as insulin and glucose test strips, if patients keep their monthly
appointments with the pharmacists. Patients also receive free glucose-monitoring
devices.
"It's unbelievable what a difference that
leverage has made," said John Miall, Asheville's risk manager and the individual
who approved and oversees the program.
The city's medical costs for the average diabetic
patient in the program have dropped to $4,651 as of February 2002 from $6,127
before the program's launch in February 1997. Patients' blood-sugar levels also
have dropped, and the number of sick days they take has declined.
At the outset, architects of the Asheville
project had hoped to realize some statistical reduction in healthcare costs.
"Nobody predicted or expected the immediate short-term improvements that we
saw," said Miall.
While Asheville's diabetes project has expanded
to include 98 patients at present, it is still a relatively small population
from which to draw broad conclusions. But Miall is hopeful that other employers
across the country will achieve similar results.
With the start-up grant from Aventis, APhA is
putting together materials and tools for the five self-insured employers to use
in starting their own programs. Two employers are launching the programs in
January, with others to follow in March and April.
"These employers recognize that the current
healthcare system is not working and they looked at what happened at Asheville
and they said, 'Hey, we want to try that too,'" said Garrett, the project
director.
As the pharmacy dispensing process becomes
increasingly automated, pharmacists are seeking to expand their role in the
healthcare continuum. The Asheville project is unique because it is one of only
a few in the country through which pharmacists get reimbursed for consulting
with patients.
"What this model does is create an opportunity
for pharmacists to use the skills they're learning in school and get paid for
it," Garrett said.
Source: Diabetes In Control Dot Com.
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