title: Disease management and medication compliance.
abstract: Lack of medication compliance is harmful to health care systems from both a clinical and economic perspective. This study examines the methods that disease management organizations employ to identify nonadherent patients and to measure effectiveness of compliance programs for patients with diabetes, hyperlipidemia, and cystic fibrosis. In addition, this study investigates the degree to which disease managers assume risk in their contracts, and whether compliance strategies are being coordinated with payers' use of value-based insurance design, in which patient cost sharing is a function of the relative value of pharmaceuticals. This study's findings suggest that disease management may be falling short in terms of: (a) comprehensive commitment to expert-recommended at-home devices used to self-diagnose and measure health indicators; (b) early adoption of expert-recommended new technologies to measure and improve compliance; (c) intensity of use of standard tests in outpatient clinics; (d) coordination of compliance strategies with payers' use of value-based insurance design; and (e) the proportion of risk assumed in disease management contracts.
authors.affiliation: Tufts Center for Study of Drug Development, Boston, Massachusetts 02111, USA. joshua.cohen@tufts.edu
authors.forename: Joshua
authors.initials: J
authors.lastname: Cohen
authors.forename: Kathyrn
authors.initials: K
authors.lastname: Christensen
authors.forename: Lanna
authors.initials: L
authors.lastname: Feldman
mesh_terms: D003550:Cystic Fibrosis / Q000188:drug therapy*; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D019468:Disease Management; D005260:Female; D019983:Guideline Adherence; D006305:Health Status Indicators; D006801:Humans; D006949:Hyperlipidemias / Q000188:drug therapy*; D007407:Interviews as Topic; D008297:Male; D055118:Medication Adherence; D012648:Self Care; D011795:Surveys and Questionnaires