Better Use of Diabetes Medicine: Solving a $4 Billion Problem

Posted on September 8, 2016

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BETTER USE OF DIABETES MEDICINES: SOLVING A $4 BILLION PROBLEM

NEHI Releases Recommendations for Optimizing Medication Use in Diabetes Care

CAMBRIDGE, MA (September 8, 2016) – The Network for Excellence in Health Innovation (NEHI) – a nonprofit, non-partisan health policy institute focused on enabling innovations that improve health, boost health care quality and produce smarter spending – released a report today, Better Use of Medicines for Diabetes Patients: Five Critical Ways to Improve Care, that outlines the challenges presented by medication use in diabetes and provides five innovative solutions to improve diabetes care.

Diabetes poses a major challenge for nation, costing the U.S. $322 billion per year and affecting nearly 30 million Americans. More than 4 in 5 Type 2 Diabetes patients are actively treated with medication, but for various reasons, including poor adherence, much of this medication isn’t used well or correctly and doesn’t benefit patients’ health. It was recently estimated that the U.S. could save approximately $4 billion in Medicare spending per year by addressing sub-optimal use of medicines for patients with diabetes. 

“It’s possible to use medications in diabetes care far more wisely than we do now, improving patients’ health, producing better care, and lowering costs,” says Susan Dentzer, NEHI’s President and CEO. “The nation needs to address barriers standing in the way of patients’ optimal use of medications, including inadequate education and training of diabetes patients, high out of pocket costs for patients, lack of competition in the market for diabetes drugs, and fragmented care.”

NEHI’s recommendations for policy makers and the private sector include the following:

• Tailor medication tools to patients’ needs – interventions such as Medicare’s Medication Therapy Management should be enhanced and targeted to the patients that need them most.
• Reduce care fragmentation – Medicare, Medicaid, and private payers need to take such steps as transferring patients’ adherence data more quickly into the hands of prescribers and allow pharmacists to bill for resolving patients’ drug therapy problems. States and others need to expand use of collaborative practice agreements so that physicians can delegate prescribing authority to other qualified professionals.
• Cut costs to payers and patients – industry and policy makers need to take steps to ensure a competitive market for diabetes medications.  Health insurance and prescription drug benefits should be designed to lower cost barriers facing patients with diabetes, and to provide incentives for optimal use of their medications, through such arrangements as value-based insurance design.

“I see patients with type 2 diabetes every week and the majority of them are facing an uphill battle. These patients have to manage their blood sugar, eat healthy, and be active.  Most of these patients take multiple medications, several times a day, often in varying doses. The burden of financial difficulties and mental illness combined with a system that doesn’t make it easy for them to navigate and learn how to manage and cope with their chronic conditions results in fragmented care that costs billions of dollars,” says Kam Capoccia, Pharm.D., BCPS, CDE, expert in chronic disease management and Clinical Associate Professor at Western New England University College of Pharmacy. “NEHI’s analysis and recommendations get to these complicated patient needs, ultimately lowering costs and improving care.”

The findings will also be released and discussed at an event and panel presentation in Washington, DC featuring:

• Natalie Aboubechara, PharmD, Pharmacist Evidence Analyst & Strategist in Drug Information Service, Kaiser Permanente Office of Pharmacy Quality and Medication Safety
• Murray Aitken, Director, IMS Institute for Healthcare Informatics
• Kam L. Capoccia, PharmD, CDE, Western New England University College of Pharmacy
• Tom Hubbard, Vice President of Policy Research, NEHI
• S. Lawrence Kocot, Director, KPMG Center for Healthcare Regulatory Insight
• Matthew Pickering, PharmD, Associate Director of Research and Quality Strategies, Pharmacy Quality Alliance

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