Pharmacy Benefit Manager Creates Innovative Program for Diabetes Care

Conference attendees at the PharmTalk: Innovative Practices in Diabetes Care presentation on Friday, March 16, at the American Pharmacists Association’s Annual Meeting & Exposition (APhA2018) in Nashville, Tennessee, learned how one independent pharmacy benefits manager (PBM) created an innovative program to help patients.

In one segment of the presentation, called Applying High-Touch Specialty Pharmacy Principles to Managing Diabetes, PattyTaddei-Allen, PharmD, BCACP, BCGP, director of outcomes research at WellDyneRx in Lakeland, Florida, talked about how the PBM figured out a way to marry cost savings with improving outcomes.

In late 2016, WellDyneRx was strategizing, thinking about what patients with diabetes both needed and wanted. The PBM knew that “diabetes is the leading driver of the traditional drug cost spend,” higher than the amount spent on oncology, multiple sclerosis, and HIV, Taddei-Allen said. It also knew that “adherence continues to be less than optimal,” she said

WellDyneRx created a comprehensive program called WellManaged-Diabetes to control costs while improving communication and outcomes.

The PBM’s US Specialty Care dedicated a team to take care of patients with diabetes. This group provides education, counseling, and one-on-one case management. The team reviews patient medications, looks at adherence, and finds discrepancies, reaching out to the provider and patient if anything is wrong, Taddei-Allen said.

In addition, the team assesses medication-taking behavior before adding on new medications, and it also looks for the most cost-effective options, available, she said.

The team includes pharmacy technicians who help enroll patients in copay cards if available and perform refill assessments.

Patients with diabetes who take part in the program get help with treatment goals, via phone and HIPAA-compliant video technology, Taddei-Allen said.

Among the uncontrolled diabetics, those who took part in the program saw the average A1C levels fall to 8.2% from 8.5%, she said.

Meanwhile, the percentage of adherent patients rose to 64% from 58%, while average co-pay costs for diabetes medications were reduced by 56%, Taddei-Allen said.

WellDyneRx plans to expand the program to more clients, dispense more medications and provide education to patients through webinars, she said.

Currently, 400 patients are part of the program, Taddei-Allen said.

Patient feedback has been positive, she said, citing the fact that the medications get shipped to their homes.

“Patients love it,” Taddei-Allen said.