Data confirm model can drive fundamental change in the U.S. health care system
Washington, D.C. (Vocus) April 6, 2009 -- Results of the Diabetes Ten City Challenge (DTCC) released today by the American Pharmacists Association (APhA) Foundation demonstrate how employers and pharmacists can work together to help people with diabetes manage their disease and reduce health care costs.
The data, which will be published in a peer reviewed article in the May/June issue of the Journal of the American Pharmacists Association (JAPhA), show average total health care costs were reduced annually by $1,079 per patient compared to projected costs if the DTCC had not been implemented. Aggregate data for 573 participants, who were in the program for an average of 14.8 months, show patients saved an average of $593 per year on their diabetes medications and supplies because employers waived co-pays to encourage people to participate in the DTCC.
According to the analysis, there also were improvements in key clinical measures - including a 23% increase in the number of participants achieving the American Diabetes Association A1C (blood glucose) goal of <7; an 11% increase in the number of participants achieving National Cholesterol Education Program goals; and a 39% increase in the number of participants with a combined diastolic/systolic blood pressure goal achievement of 130/80.
Improvements in preventive care measures also were measured: the percentage of participants with current flu vaccines increased from 32% to 65%; those with current eye exams increased from 57% to 81%; and those with current foot exams increased from 34% to 74%.
HOW THE DTCC MODEL WORKS
Through the DTCC, conducted by the APhA Foundation through HealthMapRx™ with support from GlaxoSmithKline, employers established a voluntary health benefit for employees, dependents and retirees with diabetes. Thirty employers in 10 cities waived co-payments for diabetes medications and supplies if participants met regularly with a specially trained pharmacist "coach" who helped them track their A1C, blood pressure and cholesterol and manage their disease through exercise, nutrition and other lifestyle changes. Pharmacists communicated with physicians after every visit and referred patients to other health care providers for additional care or education as needed.
"The Diabetes Ten City Challenge demonstrated the power of partnership and the impact of putting patients at the center of their own care," said Toni Fera, PharmD, director of patient self-management programs for HealthMapRx and lead author of the report.
More than 23 million Americans have diabetes at a cost of $174 billion a year. It is estimated that 200,000 people die of diabetes-related complications every year; and thousands are affected by blindness, kidney failure and problems of the lower extremities. In 2007, diabetes was responsible for 15 million work days absent, 120 million work days with reduced performance, and an additional 107 million work days lost due to unemployment disability.
APhA Foundation Vice President for Research and study co-author Benjamin M. Bluml said the DTCC offered a way for employers, pharmacists and people with diabetes to unite against the devastating disease. "The Diabetes Ten City Challenge provides a promising collaborative care model that blends important elements of a 'reformed' health care delivery process by integrating accessibility, patient-centeredness and value achieved by helping patients to make clinical improvements while managing costs," he said.
DTCC EXPANDED NATIONWIDE FOR CHRONIC DISEASES
The DTCC is modeled after several successful APhA Foundation programs that tested the pharmacist-coach model for managing chronic diseases such as asthma, cardiovascular disease, high cholesterol and osteoporosis. Earlier this year, the APhA Foundation announced a partnership with Mirixa Corporation, the nation's largest pharmacy-based patient care network, to offer the DTCC collaborative care model to employers nationwide for diabetes and other chronic diseases through HealthMapRx.
"Chronic disease is responsible for 7 of 10 American deaths and 75 percent of the nation's $2.2 trillion health care bill," said APhA Foundation CEO and study co-author William M. Ellis. "The collaboration between the APhA Foundation and Mirixa provides an opportunity to transform health care delivery in local communities and drive fundamental change in the U.S. health care system. Our goal is to make this model as widely available as possible and encourage employers to invest in helping their employees manage all chronic conditions."
HealthMapRx is a partnership of the APhA Foundation and Mirixa Corporation that offers consumer incentive programs that focus on patient self-management education and techniques to help patients with chronic conditions improve health outcomes. The HealthMapRx programs match patients to community pharmacist "coaches" who provide hands-on education, monitoring, and evaluation of health improvements. With over 80 employer sponsored health plans, the program assists thousands of patients throughout the country.
ABOUT THE APhA FOUNDATION
The American Pharmacists Association (APhA) Foundation, headquartered in Washington, D.C., is a non-profit organization affiliated with the American Pharmacists Association, the national professional society of pharmacists in the U.S. The Foundation has expertise in designing programs to seek to create a new medication use system in the U.S. where patients, pharmacists, physicians and other health care providers collaborate to dramatically improve the cost and quality of consumer health outcomes through safe and effective use of medications.
Caren Kagan Evans
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