PAYOR AND PRESCRIBER FEASIBILITY ASSESSMENT OF A PHARMACY BENEFIT MANAGEMENT (PBM) DIABETES PROGRAM UTILIZING PHARMACIST-ADVISED SELF-ADJUSTED BASAL INSULIN

Author(s)

Hamid G1, Schrader BJ1, Agatep BC1, Vazhappilly JJ1, Herrera V2, Dalal MR3, Stanek EJ1, Berria R3, Pendergrass M4, Charland SL11Medco Research Institute, LLC, Medco Health Solutions, Inc., Bethesda, MD, USA, 2Medco Research Institute, LLC, Medco Health Solutions, Inc., Franklin Lakes, NJ, USA, 3Sanofi-Aventis U.S., BRIDGEWATER, NJ, USA, 4Medco Health Solutions, Inc., Fort Worth, TX, USA

OBJECTIVES: Assess feasibility of instituting a PBM program engaging pharmacists as prescriber-extenders for care of patients with type 2 diabetes mellitus (T2DM). METHODS: Surveys included 146 payors (15 questions) and 2000 T2DM prescribers (Internal Medicine [IM], Endocrinologists/Diabetes specialists [ENDO/DS] and Family practitioners [FP]; (30 questions). After a description of a pharmacist-managed basal insulin initiation/intensification program, the survey evaluated interest and importance of program components including: adherence reports, format/content/frequency of reports, drug spend, care/management of T2DM, access to care, patient education/counseling, pharmacist training, and additional management tools.  Statistical comparisons were done by chi-square or Wilcoxon test analysis. RESULTS: Payor response rate was 13%. They included large (approx 1M), young (age 35±4) membership in the Northeast. They believe prescribers will be interested in receiving T2DM medication adherence reports (100%) and participating in the program (68%).  Importance was assigned to increased access of care (95%) and management of patients (100%), but less-so on pharmacist training (53%). The prescriber response rate was 7%: 70% ENDO/DS and 29% IM/FP. Compared to ENDO/DS, more IM/FP believe the program would improve overall care (64% vs 38%), increase patient education/counseling (57% vs 33%), and wanted T2DM medication adherence reports (76% vs 40%) [all p<0.05]. More IM/FP (43%) than ENDO/DS (19%, p<0.05) state they would refer patients to the program.  For most prescribers, financial compensation was not a driving factor, while contact of pharmacist/patient contact/dialog was important. Approximately 60% of IM/FP and 40% of ENDO/DS were willing to share blood pressure, lipid, and hemoglobin A1C values with pharmacists. CONCLUSIONS: Payors are interested in improving care and management of T2DM and endorse a PBM-based pharmacist physician-extender program. Primary care prescribers were more supportive of the program, willing to share data, and likely to refer patients than Endocrinologists/Diabetes specialists. Considering response bias, overall, the program is feasible and has been implemented.

Conference/Value in Health Info

2012-06, ISPOR 2012, Washington, D.C., USA

Value in Health, Vol. 15, No. 4 (June 2012)

Code

PDB105

Topic

Health Service Delivery & Process of Care

Topic Subcategory

Hospital and Clinical Practices

Disease

Diabetes/Endocrine/Metabolic Disorders

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