Economic and clinical impact of innovative pharmacy benefit designs in the management of diabetes pharmacotherapy.
Diabetes has enormous personal, economic, and societal costs. Despite the proven financial and clinical benefits of tight glycemic control, there remain a number of barriers to improving outcomes, including poor adherence to pharmacotherapy, which is responsible for inadequate control of diabetes and the associated financial burden. There are many factors that may affect an individual's adherence to a medication regimen, such as personal beliefs, the complexity of the regimen, and, most importantly, cost. Many benefit plans are affected by the rising cost incurred by its members, which could be potentially resolved if benefit plans think of innovative ways to promote adherence. One such example can be found in the benefit design chosen by Pitney Bowes. Their pharmacy benefit design contained diabetes medications in tier 1, which were under tier 2 in the past. Findings showed that as patient adherence increases with time, associated healthcare costs and annual pharmacy costs decrease.
Berger
Jan
J
Caremark, One Hunt Valley, 11311 McCormick Rd, Ste 230, Hunt Valley, MD 21031, USA. jan.berger@caremark.com
D003363:Cost Control; D003920:Diabetes Mellitus / Q000188:drug therapy* / Q000191:economics; D016527:Drug Costs; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000191:economics* / Q000627:therapeutic use; D007356:Insurance, Pharmaceutical Services / Q000191:economics*; D008297:Male; D008329:Managed Care Programs / Q000191:economics; D009936:Organizational Innovation; D010349:Patient Compliance; D011306:Prescription Fees; D017749:Total Quality Management; D014481:United States
D007004:Hypoglycemic Agents