title: A disease management case study in infectious disease.
abstract: One of the earliest attempts at risk sharing between a managed-care organization and a pharmaceutical company is the infectious disease management program developed since late 1993 by Intergroup of Arizona and Eli Lilly and Company (Indianapolis, Indiana) in conjunction with the Center for Pharmaceutical Economics at The University of Arizona (Tucson, Arizona) and other entities. In the first phase of the program, protocols were built around eight infectious disease states, and it was recognized that second-line antibiotics were often prescribed when more economical first-line antibiotics would be equally effective. The second phase of the program emphasized developing treatment algorithms focused on patient outcomes, using merged medical and pharmacy claims databases to determine the effects of the antibiotic changes. To implement the program successfully, some significant shifts in corporate, medical, and patient mind-sets had to be addressed. A primary goal was to encourage a movement from a rebate, volume-driven, cost structure to a shared-risk, appropriate-use, reimbursement method in which both managed-care and the pharmaceutical company incentives could mesh as far as possible. Over the long term, it is hoped that this project will lay the groundwork for other disease management programs for high-impact, frequently occurring diseases.
authors.affiliation: Integrated Pharmaceutical Services, Inc., Tucson, Arizona, USA.
authors.forename: S M
authors.initials: SM
authors.lastname: Wert
mesh_terms: D000900:Anti-Bacterial Agents / Q000191:economics / Q000627:therapeutic use; D003141:Communicable Diseases / Q000188:drug therapy / Q000191:economics*; D003365:Costs and Cost Analysis; D019468:Disease Management; D006801:Humans; D008329:Managed Care Programs / Q000191:economics; D015397:Program Evaluation
chemical_list: D000900:Anti-Bacterial Agents