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IMPROVING HEALTH CARE THROUGH
DRUG BENEFIT STRATEGIES
Programs designed to manage chronic diseases have grown significantly in recent years as they have proven their ability to achieve cost savings while improving the quality of life of the patients they serve. Disease Management is a multi-disciplinary, continuum-based approach to healthcare delivery that proactively identifies populations with, or at risk for established conditions. The necessary elements of a disease management program supports the physicians/patient relationship; emphasizes prevention of exacerbation and complications utilizing cost effective evidence-based practice guidelines and patient empowerment strategies such as self-management; and continuously evaluates clinical, humanistic and economic outcomes with the goal of improving overall health. Successful disease management programs are developed and implemented in partnership with patients, physicians, pharmacists, and other health care professionals, administrators, and payers. A 1999 survey showed that 56% of employers are offering disease management services to their employees. Further, 67% of HMOs and 64% of POS plans now offer disease management to their beneficiaries. (Disease Management, Volume 4, Number 2, 2001, page 65). Under disease management programs, a team of health care professionals first identifies patients within a specific population who are at risk of developing or currently suffering from a specific chronic disease, such as diabetes, asthma, congestive heart failure, hypertension and high cholesterol. Thereafter, the programs develop and implement strategies for those patients and their health care team on specific ways to prevent, manage and treat the chronic disease, strategies such as enrolling patients in smoking cessation programs, administering appropriate drugs, reminding patients when it's time to their physical checkups or prescription drug refills, or modifying dietary habits. Implementation of those strategies through a disease management program reduces the risks of complications, deterioration, and adverse outcomes, providing cost savings to payers and patients and enhancing the patients' physical and emotional well being. By working as a member of a disease management team, managers of pharmacy benefits and retail pharmacists can evaluate medication therapies, identify and manage drug related problems for the patient and provide advice on the disease and its management. Presenters at the June 3rd luncheon will focus one employer's perspective on why they have started to focus on disease management programs for many of their chronic employees. In addition, a leading physician and medical director from a pharmacy benefit management company will provide a case study on diabetes and how her company offers comprehensive disease management programs for employers managing chronic benefits. Finally, a leading pharmacist from a national chain drug store will
describe the invaluable role and services that community pharmacies
play in managing chronic diseases from the pharmacy perspective.
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