Volume 02, Number 2, 2011
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Browsing Volume 02, Number 2, 2011 by Author "Wertheimer, Albert I."
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Item An estimation of the effect of 100% Compliance with Diabetes Treatment: Can we reduce cost of illness with higher compliance rates?(University of Minnesota, College of Pharmacy, 2011) Koçkaya, Güvenç; Wertheimer, Albert I.Introduction: The current study was designed to estimate the direct cost of noncompliance of diabetes patients to the US health system. Understanding these expenses can inform screening and education budget policy regarding expenditure levels that can be calculated to be cost-beneficial. Materials and Method: The study was conducted in three parts. First, a computer search of National Institutes of Health websites and professional society websites for organizations with members that treat diabetes, and a PubMed search were performed to obtain the numbers required for calculations. Second, formulas were developed to estimate the risk of non-compliance and undiagnosed diabetes. Third, risk calculations were performed using the information obtained in part one and the formulas developed in part two. Results: Direct risk reduction for diabetes-related kidney disease, stroke, heart disease, and amputation were estimated for 100% compliance with diabetes treatment. Risk, case and yearly cost reduction calculated for a 100% compliance with diabetes treatment were 13.6%, 0.9 million and US$ 9.3 billion, respectively. Conclusion: Society, insurers, policy makers and other stakeholders could invest up to these amounts in screening, education and prevention efforts in an effort to reduce these costly and traumatic sequelae of noncompliant diabetes patients.Item Is Mail Service Pharmacy Cost Beneficial to Plan Sponsors?(University of Minnesota, College of Pharmacy, 2011) Vulakh, Larisa; Wertheimer, Albert I.The objective of this study was to describe and compare prescription drug costs charged to a plan sponsor for the top 50 maintenance medications provided through retail and mail service procurement channels. Data were obtained for covered beneficiaries of a health plan sponsored by an employer with just over 3,000 covered employees The analytics team at the PBM administering the plan sponsor’s prescription drug benefit provided de-identified claims information for the top 50 maintenance prescription drugs delivered through either mail service or retail procurement methods for this employer over a one year period (7/1/2008 to 6/30/2009). Based on these data, (1) dollar amount difference (mail service minus retail), and (2) percentage difference between mail and retail costs (as a percentage of the lower net cost per day) were computed. The findings revealed that 76 percent of the medication products studied were associated with a lower net cost per day to the plan sponsor through mail service procurement and 24 percent were associated with lower net cost through retail procurement.