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Case Study: Diabetes and the Asheville Project

Diabetes Management

Two employers, the City of Asheville and Mission-St. Joseph's Health System, participated in 2 initiatives targeting asthma and diabetes. A total of 194 employees met the criteria for participation in the diabetes program. The study assessed both clinical and economic outcomes for up to 5 years.¹

Program Components:

• Pharmacy care services by trained community pharmacists
• Diabetes education center, staffed by certified diabetes educators
• Patient participation incentives
• Free home blood glucose monitor
• Waiver of copayment for all diabetes drugs and related supplies such as lancets and test strips

Asheville Project (2001); Mean Cost Per Patient Per Year (USD)

Program Outcomes:

• The mean insurance cost per-patient-per-year (PPPY) decreased by $2,704, $3,609, $3,908, $5,480, and $6,502 in the first through fifth follow-up years, respectively.
• Prescription costs increased. But total mean direct medical costs PPPY decreased every year compared to the baseline.
• For one employer group, sick days were reduced for 5 consecutive years. Increased productivity value was estimated at $18,000.
• Prescription costs increased every year compared to the baseline. For the first through fifth years, increases of $656, $1,487, $1,932, $1,942, and $2,188 PPPY, respectively, were observed.
• Mean hemoglobin A1c (HbA1c) levels decreased (improved) at every follow-up.
• HbA1c levels compared to baseline for enrolled patients improved at each follow-up visit in 57.7% to 81.8% of patients.
• Mean HDL-C levels increased (improved) at every follow-up with 53.3% to 75% of patients.

Reference:

1. Cranor CW, Bunting BA, Christensen DB. The Asheville project: long-term clinical and economic outcomes of a community pharmacy diabetes care program. J Am Pharm Assoc. 2003;43(2):173-184.

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