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July 16, 2019

Four Ways to Remove the Complexity of Diabetes Management for Your Patients and Your Plan

Like many chronic conditions, the prevalence of type 2 diabetes is increasing, bringing with it rising medical and prescription drug costs. Prescription drug costs make up 30% of the total cost of treating a patient with diabetes.[1] Across the nation and in EnvisionRx’s book-of-business, diabetes represents 14% of total drug spend for most plans.[2]

Offering the lowest cost medication isn’t the only approach to lowering costs. Diabetes requires a great deal of self-management by the patient. Should a patient fail to take his or her medication as directed, for whatever reason, the result can be increased healthcare costs due to complications, unnecessary hospitalizations and comorbid conditions.

EnvisionCare is our comprehensive solution that manages all aspects of the pharmacy care experience, from formulary management and plan design through clinical support and patient engagement. Effectively managing high-cost conditions such as diabetes requires a balanced strategy to achieve optimal plan and patient outcomes.

Taking this comprehensive approach, here are four ways to simplify the complexities of diabetes management:

  1. Provide Individualized Care - No two patients are the same. As nearly one in 10 American adults have diabetes, and 40% of those with diabetes have at least three other chronic conditions, better care requires personalized attention.[3, 4] Multiple conditions mean multiple therapies and often many prescribers. For patients, this can be complicated.

    Our EnvisionCare Diabetes program targets at-risk diabetic members and their respective prescribers based on paid medication claims history and leverages a proprietary inference logic platform. Once the member is engaged, our team of clinical pharmacists and nurses, known as Care Navigators, perform a person-to-person medication review and create patient-specific care plans. We assess health goals and measurements to educate and guide patients on their drug therapies. As a result, we’re able to assist in lowering blood glucose levels by combining integrated technology, meaningful analytics and personalized clinical care.

  2. Lower Drug Costs - The average diabetes patient takes as many as eight prescriptions daily. High medication costs can drive patients to skip doses or split pills, impacting adherence. Unfortunately, lack of medication adherence can lead to bigger problems and bigger expenses. Healthcare costs for patients with diabetes are 2.3 times higher than those without the disease. In fact, $1 in $4 healthcare dollars are spent treating diabetes and its complications.[5]

    Our Care Navigators help patients overcome barriers to adherence, close gaps in care and improve general diabetes management. Through evidence-based drug therapies and therapeutic substitutions, we can help lower drug costs and improve medication adherence, which can reduce unnecessary trips to the emergency room, hospitalizations and other costly care.

  3. Offer Free Glucometers - Often diabetes patients don’t feel any symptoms of their disease until their blood sugar is either very high or very low. But these spikes can lead to organ damage and disease complications, like heart attack or stroke. Patients must learn to monitor and control blood glucose in order to better manage their disease and reduce these complications that worsen their health and increase costs.

    Our EnvisionCare Diabetes program offers a free smart glucometer to patients. We teach them how to use it, how to know their target ranges, and how to understand the impact of other factors on their blood levels. For example, factors like stress, diet and exercise can all influence blood glucose levels. Helping patients closely monitor their blood glucose at home can help them learn the impact their daily habits have on their condition.

  4. Educate on Lifestyle Choices - Beyond medication and glucose monitoring, patients with diabetes must consider their diet and lifestyle management. Smoking, poor diet and lack of exercise can worsen diabetes and can lead to many other complications. Diabetics are two to four times more likely to develop heart disease and cancer.[6] Often, lifestyle changes are a must.

    Our Care Navigators, specially trained and certified clinical pharmacists and nurses, provide educational counseling on diabetes care management on such topics as meal prep, exercise, food choices and nutrition, as well as foot, skin and eye care. We help the patient better understand their disease, its complications and affects, and how their lifestyle choices impact their health.

EnvisionRx works to simplify the complexities of diabetes care for members, resulting in reduced overall healthcare costs, improved adherence and higher member satisfaction. Our condition-focused care plan provides members with the personalized service and clinical expertise necessary to manage their condition for better health outcomes and lower plan costs.

 

[1] American Diabetes Association. The Economic Costs of Diabetes in the U.S. in 2017.

[2] Internal data.

[3] American Diabetes Association. The Economic Costs of Diabetes in the U.S. in 2017.

[4] Wolff JL, Starfield B, Anderson G. Prevalence, expenditures, and complications of multiple chronic conditions in the elderly. Arch Intern Med. 2002; 162(20):2269-2276.

[5] American Diabetes Association. The Economic Costs of Diabetes in the U.S. in 2017.

[6] Why Diabetes Matters (2015). American Heart Association. Retrieved from https://www.heart.org/en/health-topics/diabetes/why-diabetes-matters/cardiovascular-disease--diabetes.

SEE HOW ENVISIONRX IS SIMPLIFYING THE COMPLEX FOR DIABETES MANAGEMENT

Download the diabetes infographic to learn how we're managing diabetes for better adherence and lower plan costs.

erx diabetes infographic cover

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