WellManaged – Diabetes Clinical Program

Improves Clinical and Financial Outcomes with Pharmacist-Led High-Touch Therapy Approach

Diabetes is the leading cost driver for WellDyneRx clients and accounts for more than 10% of total drug spend. Adherence rates tend to be poor for diabetes medications, and overall A1c levels do not appear to be trending downward despite increases in associated drug treatment costs. To help our clients provide quality care while containing costs, WellDyneRx offers a comprehensive diabetes management program, called WellManaged – Diabetes, that increases medication adherence rates through patient education; reduces plan spend through aggressive formulary management; and improves outcomes through monitoring of key measures.

All new diabetes prescriptions are reviewed for clinical appropriateness and our pharmacists provide disease management education to all program participants. Additionally, they closely monitor medication adherence, provide patient and provider outreach as needed, and engage at-risk patients in diabetes case management. Our pharmacists also guide prescribers to the most cost-effective and clinically appropriate treatment options and share objective drug utilization data with them with the goal of increasing adherence rates.

WellManaged – Diabetes Program Drives Results

One WellManaged – Diabetes client had 380 patients actively participating in the program and baseline and recent A1c levels were obtained from 94 of them. Almost half of these patients (48) were uncontrolled at baseline (A1c>7). Of the uncontrolled patients, 56% (27) experienced A1c reductions from baseline (avg 8.8) by 1.4 to an average A1c level of 7.4. Also, 21% of uncontrolled patients at baseline converted to controlled, with an average end A1c level of 6.4. The proportion of adherent patients increased after program implementation from 75% to 90%. Compared with the previous year, this client’s total diabetes spend decreased by 4%, average member copays decreased 61%, and average total drug cost per prescription decreased by 10%.

Applying a high-touch model to delivering patient care, focused on adherence and education, improves clinical and financial outcomes. The dedicated diabetes pharmacy team ensures patients enroll in manufacturer copay cards and provides personalized diabetes coaching and education. Collaborative and ongoing communication with providers allows for optimized medication management.

2018 Quarter Three WellInformed Table Contents