Objective: To measure the effects of a pharmacist-run medication management program on medication adherence, glycemic control, and total health care expenditures. Methods: Scott & White Health Plan (SWHP) claims data were evaluated to identify high-risk diabetics aged 18-63 years, defined as those who demonstrate poor glycemic control (HbA1c >7.5%) and utilized > $600 of prescription medications the year prior to study enrollment. A control group was identified who met the same inclusion criteria, but who were not invited to the program due to geographic constraints. Medical utilization costs were analyzed beginning one year prior to study enrollment and included inpatient, outpatient, emergency department, and prescription costs. Health system charges, standardized to 2006 dollars, were used as a surrogate for costs. Intervention costs were estimated from pharmacists' wage rates. Medication adherence was calculated as medication possession ratio (MPR) of oral antidiabetic agents. HbA1c results were analyzed to determine glycemic control. Results: Analysis of 46 subjects and their matched controls one year after program implementation showed positive trends, although none of the results were statistically significant. The mean MPR for the intervention group increased from 0.69 to 0.79, while there was no change from a baseline of 0.64 for controls [p=0.24]. Intervention patients demonstrated a greater improvement (9.5% to 8.2%) in HbA1c than controls (9.5% to 8.7%) [p= 0.15]. Although total monthly health care costs increased in both the intervention ($1448 to $1756; difference = $308 ± $2016) and control groups ($1089 to $1745; difference = $656 ± $2641) [p = 0.46], the increase was lower in the intervention group. Conclusion: Patients in the intervention group trended toward better medication adherence and a greater decline in HbA1c than controls. We expect the trend of cost savings will continue and strengthen in the future due to long-term benefits associated with sustained glycemic control.