title: Pharmacoeconomic analysis of the diabetes initiative program: a pharmacist-physician collaborative care model.
abstract: BACKGROUND
  Diabetes treatment cost increased 41% from 2007 to 2011. Pharmacists have provided collaborative diabetes management for decades with improvement in disease-related end points. Few have reported economic benefits of pharmacist management of type 2 diabetes.
  
  
  OBJECTIVE
  The purpose was to determine if cost savings associated with hemoglobin A1c (A1C) and systolic blood pressure (SBP) change outweighed programmatic pharmacist-physician collaborative care model costs.
  
  
  METHODS
  This cost analysis of a 12 month, prospective, multicenter, observational study included English-speaking adults, 18 years or older, with type 2 diabetes mellitus, a life expectancy >1 year, and either a A1C >7%, SBP >130 mm Hg, diastolic blood pressure >80 mm Hg, or low-density lipoprotein concentration >100 mg/dL. Pregnant patients were excluded. Primary analysis outcome was average cost per outcome, ratio of net cost (numerator) and percentage achieving outcomes (denominator). Assessment outcomes included A1C reduction by at least 1% and SBP reduction by at least 5.6 mm Hg.
  
  
  RESULTS
  206 patients were seen by pharmacists during 1612 encounters (mean = 7.8 encounters/patient). Pharmacists spent 983 hours caring for type 2 diabetes patients (mean 3.8 hours/patient). Base case net labor and program costs per patient were -$66.77 and $106.81, respectively. Improvement in A1C and SBP yielded $421.01 in cost savings per patient. Labor and program average costs per patient for each outcome achieved were -$100.40 and $160.61, respectively.
  
  
  CONCLUSIONS
  This multisite pharmacist-physician collaboration in diabetes management showed cost savings when assessing pharmacist labor costs alone. Total program costs, including overhead, slightly increased cost of care.
authors.affiliation: University of Tennessee Health Science Center College of Pharmacy, Memphis, TN, USA.
authors.forename: Brandi E
authors.initials: BE
authors.lastname: Franklin
authors.forename: Michelle Z
authors.initials: MZ
authors.lastname: Farland
authors.forename: Jeremy
authors.initials: J
authors.lastname: Thomas
authors.forename: M Shawn
authors.initials: MS
authors.lastname: McFarland
authors.forename: Shaunta' M
authors.initials: SM
authors.lastname: Ray
authors.forename: Debbie C
authors.initials: DC
authors.lastname: Byrd
mesh_terms: D001794:Blood Pressure; D003299:Cooperative Behavior; D003365:Costs and Cost Analysis; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy / Q000191:economics* / Q000503:physiopathology; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D008297:Male; D054539:Medication Therapy Management; D010348:Patient Care Team / Q000191:economics; D010595:Pharmacists / Q000191:economics*; D010820:Physicians / Q000191:economics*
chemical_list: D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; C517652:hemoglobin A1c protein, human
keywords: clinical pharmacy; collaborative care; diabetes; pharmacist; pharmacoeconomics