Comprehensive MTM Saves Money, Improves Outcomes for Diabetes Patients

NOVEMBER 11, 2016
Jeannette Y. Wick, RPh, MBA, FASCP

Chronic diseases in the United States have a tremendous economic burden. Thirty-four percent of the economic burden of diabetes is attributed to the privately insured population.
Diabetes is a costly and complex condition that requires many interventions: diet and exercise modifications, glucose readings, medication adherence, insulin dosing, laboratory tests, appointments, and follow-ups. These are necessary actions to manage diabetes successfully and prevent its complications, but managing all of these requirements can be confusing and unsettling for a patient.
Employers have tried to target their employees’ conditions through wellness and disease-management programs, but none have attempted to offer comprehensive medication therapy management (MTM).
Fortunately, a team of researchers affiliated with University of Maryland School of Pharmacy has found that a pharmacist-driven, patient-centered model of care can improve clinical outcomes and reduce costs of care for diabetes. Published ahead-of-print in the Journal of the American Pharmacists Association, this is a must-read for pharmacists who wish to promote comprehensive MTM.
The researchers’ aim was to determine the effectiveness and cost-savings of a real-world, continuous, pharmacist-delivered service. The Patients, Pharmacists Partnerships (P3 Program) was offered as an “opt-in” benefit to employees of 6 public and private self-insured employers in Maryland and Virginia. A network of 50 licensed pharmacists trained in diabetes and cardiovascular disease management, comprehensive MTM, and self-management coaching delivered this service. Six hundred and two patients were studied with an average follow-up of 2.5 years per patient.  
The study findings show that patients in the P3 Program had statistically significant improvements in glycated hemoglobin (–0.41%), low-density lipoprotein levels (–4.7 mg/dL), systolic blood pressure (–2.3 mm Hg), and diastolic blood pressure (–2.4 mm Hg). Annual healthcare costs to employers declined by $1031 per beneficiary.
With the aging population comes an increase in chronic diseases and associated costs to manage them. Pharmacist-driven programs such as the P3 program that deliver comprehensive MTM can help manage these diseases and decrease employers' medical spending.
Employers can align payment systems with financial incentives for physicians, patients, and pharmacists to collaborate on patient-centered, team-based care. Pharmacist provider status in payment models could be helpful in future studies considering both costs and clinical outcomes.