Medications To Treat diabetes were the top contributor to drug trend in 2007, according to Medco Health Solutions' 2008 Drug
Trend Report.
"The increased prevalence of diabetes has clearly accelerated drug spending for this group, which includes insulin and drugs
to control blood glucose levels," says Susan O'Connor, senior director of medical initiatives at Medco.
It is important to look at the trend drivers in terms of how they compare and change year over year.
"For example, in 2006, the number one driver of trend was the lipid-lowering class, which wasn't even a factor in the top
10 trend drivers in 2007," O'Connor says. "The reason for this steep decline was the introduction of generics to this therapeutic
class, which resulted in a sharp decline in price for generic alternatives and translated into substantial savings for plans."
The therapeutic classes for diabetes and respiratory were second and third, respectively, in 2006 and are numbers one and
two for 2007.
"These classes continue to be significant factors contributing to overall trend," says Keith Bradbury, Medco's executive director
of drug information, formulary development and pharmacogenomics at Medco.
Top 10 DRUG trend Drivers in 2007
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In another example of how the introduction of generics influenced the trend drivers, anti-hypertensives were number five in
2006 but were not in the top 10 at all in 2007.
Managed care executives should develop or continue to promote weight-loss programs, programs that encourage healthy behaviors
and those that educate members about the causes of diabetes, the experts agree.
"Screening plan members for pre-diabetes or to diagnose diabetes is also an important action that should be considered," Bradbury
says.
HealthPartners aims to take an integrated approach to diabetes that reaches patients across the continuum of care, according
to Pat Courneya, MD, HealthPartners associate medical director.
For patients who are healthy or at-risk of developing diabetes, HealthPartners identifies risk factors that lead to the development
of diabetes.
The plan uses a health assessment to identify the specific behaviors that put a patient at risk of developing diabetes. The
health assessment uses a validated algorithm to categorize three levels of risk: healthy, at-risk of developing chronic illness
in two years, and chronically ill.
HealthPartners found that when members simply complete the health assessment, it can realize a net reduction in medical claims
of $54 per member. Also, in a recent analysis of five health improvement programs, including diabetes, the health plan found
a reduction in medical claims costs of $355 per engaged patient.
In addition, a HealthPartners pilot program with the state of Minnesota provides a financial incentive to patients with diabetes
to participate in a medication therapy management program.
"The program reduced emergency room visits and hospital stays and improved health risk factors that can lead to serious medical
problems such as amputations, blindness and heart attacks," Dr. Courneya says. "There were fewer emergency room visits and
24% fewer hospital admissions compared with patients who chose not to participate."
—Tracey Walker
Commentary is independent of source data
