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Case Study: The Diabetes Ten City Challenge

The Diabetes Ten City Challenge (DTCC) supports participating employers within ten cities to help manage diabetes within their covered populations. The DTCC uses community pharmacists, financial incentives and a self-management tool to help participants with their care plan.

Initial Results

Healthcare costs dropped:

The data show average total health care costs were reduced annually by $1,079 per patient compared to projected costs if the DTCC had not been implemented. Aggregate data for 573 participants, who were in the program for an average of over 14 months, show patients saved an average of $593 per year on their diabetes medications and supplies because employers waived their co-pays to encourage patients to participate in the DTCC.

According to the analysis, there also were improvements in key clinical measures - including HbA1c (blood glucose), cholesterol and blood pressure – and increases in preventive care measures, including the number of people with current influenza vaccinations, eye exams and foot exams.

Program Components

• Employers established a voluntary health benefit for employees, dependents and retirees with diabetes.
• Thirty employers in 10 cities waived copayments for diabetes medications and supplies if participants met regularly with a specially trained pharmacist “coach”.
• Pharmacists communicated with physicians after every visit and referred patients to other healthcare providers for additional care or education as needed.

DTCC Personal Triumphs

--TAMPA BAY, FL. In the first year of implementing the DTCC as part of the comprehensive health management and support programs for employees of the Manatee County Government and the Pinellas County Sheriff’s Office, the county’s cost for diabetes-related hospital admissions dropped from $500,000 to around $70,000 and has stayed in that range for three years.

--DALTON, GA. This city represents a smaller market with a high percentage of manufacturing jobs. The results have been positive with patients receiving one-on-one guidance from health professionals. In fact, one participant lost 20 pounds and reduced his HbA1c to 5.8 from an original level over 7 during the program. He also used his employer’s health club membership to swim more, and won six medals at the state senior competition.

--HONOLULU, HI. Personal health and dietary coaching have made a difference in the lives of patients in Hawaii. One man in the study noted that “A lot of times you only see a doctor for five minutes, you talk briefly and you’re out of there. With my pharmacist coach, I am able to sit down, talk about what’s going on and not feel rushed.” After sitting with his coach and learning about the high glycemic levels of many traditional Hawaiian foods, this participant lowered his HbA1c level from 11 to 6.9 over two years.

--CUMBERLAND, MD. Western Maryland Health System, a large employer and the only hospital in Allegany County Maryland, immediately recognized the benefit of joining the DTCC. They welcomed the potential savings of the proactive approach. Cumberland-area study participants appreciated the plan as well. A local pastor and his wife learned how to manage their diabetes together, using blood monitoring and exercise. The pastor dropped 36 lbs and his wife lost 11. And now they’re enthusiastically spreading the good news of proactive health management to their entire congregation.

To learn more, go to www.DiabetesTenCityChallenge.com

The DTCC program was sponsored by the American Pharmacists Assosiation with support from GlaxoSmithKline.

Reference: Journal of the American Pharmacists Association, May/June 2009. Diabetes Ten City Challenge: Final economic and clinical results