November 22, 2016
Pharmacist-provided comprehensive medication therapy management services may have a positive impact on clinical and economic outcomes, according to a recent study.
Complicated health insurance plans and a lack of clarity about appropriate medications can make it difficult for many patients to manage their diabetes. As a result, some institutions have experimented with programs to improve provider response and patient outcomes.
In a study conducted at 6 public and private self-insured employers in Maryland and Virginia, researchers led by Magaly Rodriguez de Bittner, PharmD, BCPS, CDE, FAPhA, University of Maryland, Baltimore, implemented the Patients, Pharmacists Partnerships (P3) program as an opt-in option for employees to see if pharmacist counseling could cost-effectively improve outcomes.
A total of 602 patients with type 1 and 2 diabetes were enrolled in the program and studied between July 2006 and May 2012. Employees were offered incentives to encourage participation, including waived medication copayments and free diabetes self-monitoring supplies. Additionally, there was no cost to the employees for participating in the study.
At 2.5 years average follow-up, researchers observed significant improvements in patient outcomes, as evidenced by decreases in A1c (−0.41%, P<0.001), low-density lipoprotein levels (−4.7 mg/dL, P = 0.003), systolic blood pressure (−2.3 mm Hg, P = 0.001), and diastolic blood pressure (−2.4 mm Hg, P <0.001).
The program also had significant economic benefits, reducing total annual health care costs to employees by $1031 per beneficiary. Emergency and hospital utilization costs were also significantly reduced compared to figures recorded prior to P3 implementation.
From these results, the team concluded that the P3 program improved both clinical and economic outcomes for patients with type 2 diabetes. Pharmacists counseling should therefore be included as a required element of insurance offered by employers and health insurance exchanges, they added.—Sean McGuire