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    New therapies show promise in treating diabetes


    Non-pharmacologic treatments


    Continued development of non-pharmacologic treatments is expected. Three key areas to watch, according to Kim White, vice president, Numerof & Associates, Inc., include:

    ·      Artificial pancreas technology,

    ·      Islet cell transplantation, and

    ·      Medical management technology.

    Artificial pancreas technology continuously monitors blood glucose levels and adjusts insulin doses automatically. According to White, an artificial pancreas device from Medtronic was approved last fall and Bigfoot Biomedical and Insulet Corporation are currently working on similar technology.

    Islet cell transplantation is being studied for type 1 diabetes, says White. According to the American Diabetes Association, islets are clusters of cells in the pancreas that make insulin. Islet cell transplantation is a procedure in which islets from the pancreas of a deceased organ donor are purified, processed, and transferred to another person.

    “Although first identified as a way to treat people with type 1 diabetes in the 1960s, islet cell transplantation has been difficult to develop as a viable treatment for type 1 diabetes, which is due largely to the challenges of collecting enough islet cells to transplant and preventing transplant rejection,” says White. “However, last year an NIH [National Institutes of Health]-funded study was completed that will pave the way for manufacturing of purified human pancreatic islet cells.”

    Mobile technology has been a growing area of interest for diabetes management, says White. Although many blood glucose monitor manufacturers already have web-based programs and apps available to support diabetes management, there is ongoing research by numerous companies to better connect physicians and patients to patients’ blood glucose levels and other measurements like blood pressure.

    Business implications

    Peterson says these new products will add more competitors to the already existing therapy classes, helping to mitigate the increasing trend within the diabetes class.

    He explains that the trend in the diabetes therapy class is just one example of why it is critical for payers to manage their benefit. Express Scripts has developed several initiatives to address the affordability and accessibility of diabetes treatments including a new partnership with Eli Lilly and Blink Health that will provide a 40% discount on Eli Lilly insulin products for uninsured patients with diabetes.

    Express Scripts also recently launched a diabetes remote monitoring solution to improve outcomes and address the 42.8% of people with diabetes who are nonadherent to therapy. By using a connected glucose meter and ongoing monitoring from their Diabetes Therapeutic Resource Center, patients learn how to control their blood sugar levels, according to Express Scripts.

    “The challenge facing managed healthcare executives is striking the right balance between providing the necessary support to prevent, treat and manage the disease with ensuring the patient is compliant and adheres to physician guidance,” says White. “The current developments [in the pipeline] have the potential to dramatically improve patient outcomes by minimizing individual errors caused by missed or inappropriate medication dosing and developing accountability loops with providers.”


    Erin Bastick, PharmD, RPh, is a staff pharmacist at Southwest General Health Center in Middleburg Heights, Ohio.


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