APhA rolls out first-ever diabetes management plan

Drug Store News,  Jan 15, 2007  by Jim Frederick

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WASHINGTON -- The largest pilot test to date of a pharmacy-based diabetes management program is about to get under way.

The American Pharmacists Association Foundation revealed in December that it has completed a lengthy, coast-to-coast process under which more than 30 employers in 10 cities across the United States will join forces with local pharmacies to provide health benefits to thousands of employees and their families. The program, known as the Diabetes Ten City Challenge is modeled after the groundbreaking Asheville Project in North Carolina, a diabetes management program started 10 years ago that has been shown to improve overall health, reduce absenteeism, shorten hospital stays and reduce health care costs.

The 10 regions selected to participate are Charleston/Spartanburg, S.C.; Chicago, Ill.; Colorado Springs, Colo.; Cumberland, Md.; Dalton, Ga.; Honolulu, Hawaii; Los Angeles, Calif.; Milwaukee, Wis.; Pittsburgh, Pa.; and Tampa Bay, Fla. A total of 31 public and private employers in those cities will make the pharmacy-based diabetes management program available to employees and their dependents, on a voluntary basis.

"This is an important milestone for our program with all 10 DTCC locations actively recruiting patients," said APhA Foundation chief executive officer William Ellis. "Nearly 1,000 people already are participating in this ... employer-based diabetes management program."

The foundation kicked off the Diabetes Ten City Challenge in 2005, and pushed its expansion throughout 2006. Ellis called it "the first-ever national pilot seeking to prove that this model can be used effectively anywhere in the country," and said financial backing from GlaxoSmithKline would "allow the research results to be analyzed and shared to encourage widespread adoption of the program."

The program provides incentives through waived co-pays for diabetes medications and supplies, and helps people manage their diabetes with help from a pharmacist coach in collaboration with physicians and diabetes educators. Participating are pharmacists from state associations, independent pharmacies, supermarkets and chains, all of whom have received training by the APhA Foundation. They'll also get the group's Patient Self-Management Program software and tools to analyze clinical results, patient satisfaction and financial data for the program.

Those data are already being collected in several DTCC cities, including Pittsburgh, Dalton and Charleston, where pharmacists began patient visits in 2006.

Preliminary results for the program are expected to be available by second quarter 2007, the foundation reports. But anecdotal evidence already gathered shows clinical improvements that are consistent with past experience, said Dan Garrett, APhA Foundation's senior director of medication adherence programs and one of the founders of the Asheville Project.

"Our experience shows that cost savings typically follow clinical improvements," Garrett noted. "Results of the Asheville Project model showed that people are more likely to take prescribed medications and track their conditions, and as a result their employers saved between $1,622 and $3,356 per participant annually based on reduced emergency room visits and fewer diabetes-related hospitalizations."

The 31 employer participants include six municipal governments, three county governments, three utilities, three supermarket chains, one school, one association, three health care systems, three universities and eight corporations.

"One of our major goals ... is to demonstrate that the Asheville model can be replicated," Garrett said. "There are now over a thousand people in Asheville alone getting a new level of diabetes care that is going to dramatically change their lives.

"Our hope for the future is that we will have more data to support that this model is not only replicable and scalable, but that it truly can be done anywhere."

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