Diabetes may be a common illness for us living in the 21st Century, but it’s not new. The Egyptians first recognized it around 1500 B.C.E. And the disease is so widespread that in 2010, it killed more Americans than AIDS and breast cancer combined. According to the American Diabetes Association, 9.4% of the population in the U.S. has some form of diabetes. Unfortunately, people who are diagnosed with diabetes have a 2.3 times higher medical expenditure than their healthy counterparts. Because of this high cost of care, one of our clients reached out to us looking for cost saving opportunities in their benefits data. We created an analysis that looked at diabetes-related pharmacy savings and came to some surprising conclusions.
Let’s take a look at how benefit managers can cut costs in diabetes care while still providing great benefits for their employees.
In our client’s population, we found that 21 members were treating their diabetes with Fortamet. Fortamet is a medication used to control high blood sugar and prescribed for Type II diabetes sufferers. Fortamet costs $1,785 dollars per person each month. Our clinical staff suggested running an analysis to show the client how the generic Metformin, a drug with the same molecular composition, compared to Fortament. We found it costs just 10 cents per patient each month.
With formulary management, employers can find wasteful spending in their prescription benefit. Using a data warehouse to mine your Rx information can arm you with the proper information to work with your PBM to find those costly drugs and the appropriate, less expensive clinical substitutions.
The next step in this analysis was to take a closer look at wellness program utilization. When organizations manage chronic disease, they usually offer some lifestyle management programs because employees see the benefits of these type of programs in the long term. If a person changes their diet and exercise habits when they are prediabetic, it can help them avoid costly medications or difficult lifestyle changes in the future.
Some employers offer gestational diabetes programs, healthy living workshops and education and disease management programs that could help keep their population healthy and reduce the risk of developing any additional complications from their diabetes diagnosis.
Looking at the success and engagement in the client’s weight loss program, we recommended implementation of new wellness programs. This is because we analyzed the number of members enrolled in their benefits program, trends over time, weight loss program engagement, and more.
These are just two ways that benefit managers can help with diabetes-related spending. With a next-generation data warehouse like Artemis, businesses can cut costs or justify new programs that will help members stay healthy. We do this by identifying wasted spending, helping build cases for new or existing programs, and measuring results.
And that’s what sets Artemis apart from the rest. We help our clients find savings and determine which programs work best for their employees.