Pharmacoeconomic Analysis of the Diabetes Initiative Program: A Pharmacist-Physician Collaborative Care Model

Brandi Franklin, Michelle Z. Farland, Jeremy Thomas, M. Shawn McFarland, Shaunta' Chamberlin, Debbie C. Byrd

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background: Diabetes treatment cost increased 41% from 2007 to 2011. Pharmacists have provided collaborative diabetes management for decades with improvement in disease-related end points. Few have reported economic benefits of pharmacist management of type 2 diabetes. Objective: The purpose was to determine if cost savings associated with hemoglobin A1c (A1C) and systolic blood pressure (SBP) change outweighed programmatic pharmacist-physician collaborative care model costs. Methods: This cost analysis of a 12 month, prospective, multicenter, observational study included English-speaking adults, 18 years or older, with type 2 diabetes mellitus, a life expectancy >1 year, and either a A1C >7%, SBP >130 mm Hg, diastolic blood pressure >80 mm Hg, or low-density lipoprotein concentration >100 mg/dL. Pregnant patients were excluded. Primary analysis outcome was average cost per outcome, ratio of net cost (numerator) and percentage achieving outcomes (denominator). Assessment outcomes included A1C reduction by at least 1% and SBP reduction by at least 5.6 mm Hg. Results: 206 patients were seen by pharmacists during 1612 encounters (mean = 7.8 encounters/patient). Pharmacists spent 983 hours caring for type 2 diabetes patients (mean 3.8 hours/patient). Base case net labor and program costs per patient were -$66.77 and $106.81, respectively. Improvement in A1C and SBP yielded $421.01 in cost savings per patient. Labor and program average costs per patient for each outcome achieved were -$100.40 and $160.61, respectively. Conclusions: This multisite pharmacist-physician collaboration in diabetes management showed cost savings when assessing pharmacist labor costs alone. Total program costs, including overhead, slightly increased cost of care.

Original languageEnglish (US)
Pages (from-to)1627-1634
Number of pages8
JournalAnnals of Pharmacotherapy
Volume47
Issue number12
DOIs
StatePublished - Dec 1 2013

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Pharmaceutical Economics
Pharmacists
Blood Pressure
Physicians
Costs and Cost Analysis
Cost Savings
Type 2 Diabetes Mellitus
Life Expectancy
LDL Lipoproteins
Health Care Costs
Multicenter Studies
Observational Studies
Hemoglobins
Economics
Outcome Assessment (Health Care)

All Science Journal Classification (ASJC) codes

  • Pharmacology (medical)

Cite this

Pharmacoeconomic Analysis of the Diabetes Initiative Program : A Pharmacist-Physician Collaborative Care Model. / Franklin, Brandi; Farland, Michelle Z.; Thomas, Jeremy; McFarland, M. Shawn; Chamberlin, Shaunta'; Byrd, Debbie C.

In: Annals of Pharmacotherapy, Vol. 47, No. 12, 01.12.2013, p. 1627-1634.

Research output: Contribution to journalArticle

Franklin, Brandi ; Farland, Michelle Z. ; Thomas, Jeremy ; McFarland, M. Shawn ; Chamberlin, Shaunta' ; Byrd, Debbie C. / Pharmacoeconomic Analysis of the Diabetes Initiative Program : A Pharmacist-Physician Collaborative Care Model. In: Annals of Pharmacotherapy. 2013 ; Vol. 47, No. 12. pp. 1627-1634.
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abstract = "Background: Diabetes treatment cost increased 41{\%} from 2007 to 2011. Pharmacists have provided collaborative diabetes management for decades with improvement in disease-related end points. Few have reported economic benefits of pharmacist management of type 2 diabetes. Objective: The purpose was to determine if cost savings associated with hemoglobin A1c (A1C) and systolic blood pressure (SBP) change outweighed programmatic pharmacist-physician collaborative care model costs. Methods: This cost analysis of a 12 month, prospective, multicenter, observational study included English-speaking adults, 18 years or older, with type 2 diabetes mellitus, a life expectancy >1 year, and either a A1C >7{\%}, SBP >130 mm Hg, diastolic blood pressure >80 mm Hg, or low-density lipoprotein concentration >100 mg/dL. Pregnant patients were excluded. Primary analysis outcome was average cost per outcome, ratio of net cost (numerator) and percentage achieving outcomes (denominator). Assessment outcomes included A1C reduction by at least 1{\%} and SBP reduction by at least 5.6 mm Hg. Results: 206 patients were seen by pharmacists during 1612 encounters (mean = 7.8 encounters/patient). Pharmacists spent 983 hours caring for type 2 diabetes patients (mean 3.8 hours/patient). Base case net labor and program costs per patient were -$66.77 and $106.81, respectively. Improvement in A1C and SBP yielded $421.01 in cost savings per patient. Labor and program average costs per patient for each outcome achieved were -$100.40 and $160.61, respectively. Conclusions: This multisite pharmacist-physician collaboration in diabetes management showed cost savings when assessing pharmacist labor costs alone. Total program costs, including overhead, slightly increased cost of care.",
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