OBJECTIVES: Research indicates that decreases in A1C from 9% to 8% reduce health-care cost differentials by $1101 per diabetic and $1597 per hypertensive-diabetic over a 3-year period. To combat diabetes and its related health care costs, a pharmacist-driven community-based diabetes care program was implemented in southern Texas. Both clinical and economic outcomes from this program are presented. METHODS: Patients with type-2 diabetes were referred to this program. Patients scheduled one to three visits, based on clinical parameters, with specially-trained pharmacists and received education, glucose-meter training and onsite laboratory testing. Data including demographics, laboratory, medical, social history and pharmacist medication recommendations were entered into a relational database (Microsoft Access(r)). Differential cost and annual medical inflation rate were obtained from the literature. Program effectiveness was evaluated using a random coefficient model for continuous and GEE for binary outcomes. RESULTS: A total of 1795 patients were seen at first visit. 827 (46%) completed a second, and 389 (22%) completed a third visit. Of those who completed 3 visits, 369 (95%) continued to receive monitoring of A1C levels. Eighty percent of patients (297 of 369) received pharmacist education alone and had a significantly reduced average A1C from 7.37% to 7.08% (p <0.0001) from visit one to three. Twenty percent of the patients (72 of 369) received pharmacist diabetes education and medication recommendations and had reduced average A1C levels, 8.95% to 7.98% (p <0.0001) from visit one to three. Of the 72 patients, 47% were hypertensive-diabetics (systolic blood pressure > 140 or diastolic blood pressure > 90). Among the 34 hypertensive-diabetics and 38 non-hypertensive-diabetics, potential per-patient medical cost savings based on A1C reduction, averaged $1280 ($92,149), over a 3-year period. CONCLUSIONS: Pharmacist diabetes education and medication recommendations performed in a community setting significantly decreased A1C in type-2 diabetics resulting in a potential reduction in health care costs of $1280 per-patient, over three years.