Supplements | Pathways to Success: Utilizing Managed Care Models to Improve Clinical and Economic Outcomes in Diabetes [CME/CPE]

CME Information

Release date: June 15, 2013 |  Expiration date: June 15, 2014
Estimated time to complete activity: 2.5 hours
Type of Activity: Knowledge

This activity is supported by an educational grant from Amylin Pharmaceuticals.

Intended Audience
Medical directors, pharmacy directors, specialty pharmacists, and other managed care professionals who oversee the care of patients with T2DM in various clinical settings.

Statement of Educational Need
Diabetes mellitus (DM) is a complex and progressive disease associated with significant morbidity and mortality. As a result of the rapid aging of the baby boomer population, both the prevalence and economic burden associated with DM have been steadily increasing and are projected to continue to increase. A series of cost reports published by the American Diabetes Association (ADA) between 1997 and 2012 have suggested that direct medical costs are the primary cost driver in DM. Direct costs have increased more than 5-fold during this time frame, from $44 billion to $176 billion annually, likely due to both the increased prevalence of DM and increased costs of providing DM-related care.

The development of new classes of blood glucose–lowering medications to supplement older therapies has certainly broadened the palette of available treatment strategies. However, the growing number of available treatments and the number of reviews and guidelines published in recent years have heightened the uncertainty that accompanies selection of appropriate therapeutic regimens for the heterogeneous population of patients with diabetes. Moreover, despite evidence of the clear benefits of achieving and maintaining glycemic goals and the availability of newer and potentially more efficacious drugs, the number of patients with poor glycemic control has not substantially decreased over the past 10 years.

A comprehensive assessment of unmet needs for the population with DM is essential for more effective population management. An approach that strives to identify and reduce barriers to patients receiving optimal care and being active participants in their DM management will facilitate systemwide efforts to improve DM outcomes. Managed care organizations are particularly positioned to attempt to make the changes necessary to reduce the burdens associated with type 2 DM (T2DM) by developing policies that align with evidence-based DM management guidelines and other resources.

This activity provides an overview of the etiology and pathophysiology of T2DM, including factors that contribute to suboptimal glucose control. The activity also explores current clinical practice guidelines and algorithms, evaluates new and emerging treatment strategies, and addresses managed care aspects of managing T2DM, including the impact of disease management programs on clinical measures, healthcare expenditures, and inpatient utilization.

Educational Objectives
Upon completion of the educational activity, the participant should be able to:
  • Discuss the incidence and pathophysiology of type 2 diabetes mellitus (T2DM)
  • Explore the etiology of progressing T2DM, including factors that contribute to suboptimal control of glucose and other clinical metrics
  • Review current clinical practice guidelines and algorithms that focus on the management of treatment-experienced patients with poorly controlled DM
  • Evaluate new and emerging treatment strategies for T2DM, including various combination regimens
  • Explore managed care aspects of managing T2DM, including the impact of disease management programs on clinical measures, healthcare expenditures, and inpatient utilization
  • Discuss how treatment guidelines and other evidence are used to develop and implement medical policies relative to the management of diabetes

Disclosure Policy
According to the disclosure policies of the Physicians’ Education Resource, LLC (PER), and Pharmacy Times Office of Continuing Professional Education, all persons who are in a position to control content are required to disclose any relevant financial relationships with commercial interests. If a conflict is identified, it is the responsibility of the PER and Pharmacy Times Office of Continuing Professional Education to initiate a mechanism to resolve the conflict(s). The existence of these relationships is not viewed as implying bias or decreasing the value of the activity. All educational materials are reviewed for fair balance, scientific objectivity of studies reported, and levels of evidence.

Activity Fee
Physician: This activity is free of charge for physician participants requesting AMA PRA Category 1 Credit™.
Pharmacist: The activity is free for participants submitting evaluation forms and posttests online for pharmacy credit. For participants submitting their posttests/evaluation forms and requests for credit via fax or mail, there is a nominal fee of $10.00.

Physician Credit
Accreditation Statement
This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of Physicians’ Education Resource and the Pharmacy Times Office of Continuing Professional Education. Physicians’ Education Resource is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation
Physicians’ Education Resource designates this journal-based CME activity for a maximum of 2.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation
in the activity.

Pharmacist Credit
Accreditation Statement
Pharmacy Times Office of Continuing Professional Education is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education. This activity is approved for 2.5 contact hours (.25 CEUs) under the ACPE universal activity number 0290-9999-13-135-H01-P. The activity is available for CE credit through June 15, 2014.

Obtaining Credit
Participants must read each article in this supplement, complete the posttest achieving a passing score of 70% or higher, and complete an evaluation and request for credit. Detailed instructions on obtaining a CME certificate (physicians) or statement of credit (pharmacists) are included on the evaluation/posttest page contained in this supplement.

Off-Label Disclosure and Disclaimer
The contents of this CME/CE supplement may include information regarding the use of products that may be inconsistent with or outside the approved labeling for these products in the United States. Physicians and pharmacists should note that the use of these products outside current approved labeling is considered experimental and are advised to consult prescribing information for these products.

For additional information about approved uses, including approved indications, contraindications, and warnings, participants are advised to consult prescribing information for all products discussed. The information provided in this CME/CE activity is for continuing medical and pharmacy education purposes only and is not meant to substitute for the independent medical or pharmacy judgment of a physician or pharmacist relative to diagnostic, treatment, or management options for a specific patient’s medical condition.

The opinions expressed in the content are solely those of the individual faculty members and do not reflect those of The American Journal of Managed Care, Physicians’ Education Resource®, LLC, the Pharmacy Times Office of Continuing Professional Education, or any of the companies that provided commercial support for this CME/CE activity.

Faculty

Carrie McAdam Marx, PhD, RPh
Research Associate Professor
Department of Pharmacotherapy
Pharmacotherapy Outcomes Research Center
University of Utah
Salt Lake City, Utah

Mark E. Molitch, MD
Martha Leland Sherwin Professor of Endocrinology
Division of Endocrinology, Metabolism and Molecular Medicine
Northwestern University Feinberg School of Medicine
Chicago, Illinois

E. Albert Tzeel, MD, MHSA
National Medical Director
HumanaOne, Humana Inc.
Milwaukee, Wisconsin

Contributing Editorial Support

William Perlman, PhD, CMPP
Medical Director
Long Valley, NJ

Faculty Disclosures
These faculty have disclosed the following relevant commercial financial relationships or affiliations in the past 12 months.

Carrie McAdam Marx, PhD, RPh
Consultant/advisory board: GlaxoSmithKline, Novo Nordisk
Research grant: Bristol-Myers Squibb

Mark E. Molitch, MD
Consultant/advisory board: Abbott, Janssen, Lilly, Novartis, Novo Nordisk
Expert testimony: Janssen
Grants: Lilly, Novartis, Novo Nordisk, Sanofi

E. Albert Tzeel, MD, MHSA
Consultant/advisory board: Amylin Pharmaceuticals
Employment/stock ownership: Humana Inc

The American Journal of Managed Care
Publishing Staff—Jeff D. Prescott, PharmD, RPh; Kara Guarini, MS; and Ida Delmendo have no relevant financial relationships with commercial
interests to disclose.
 
PER and Pharmacy Times Office of Continuing Professional Education
Planning Staff—Judy V. Lum, MPA; Elena Beyzarov, PharmD; and Ann C. Lichti, CCMEP, have no relevant financial relationships with commercial interests to disclose.
 
PER and Pharmacy Times Office of Continuing Professional Education uses an anonymous peer review process to resolve conflicts of interest. The peer reviewers of this CME/CE activity have no relevant financial relationships with commercial interests to disclose.

Signed disclosures are on file at the office of The American Journal of Managed Care, Plainsboro, New Jersey.

Opinions expressed by authors, contributors, and advertisers are their own and not necessarily those of Clinical Care Targeted Communications, LLC, d/b/a Managed Care & Healthcare Communications, LLC, the editorial staff, or any member of the editorial advisory board. Clinical Care Targeted Communications, LLC, d/b/a Managed Care & Healthcare Communications, LLC, is not responsible for accuracy of dosages given in articles printed herein. The appearance of advertisements in this publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality, or safety. Clinical Care Targeted Communications, LLC, d/b/a Managed Care & Healthcare Communications, LLC, disclaims responsibility for any injury to persons or property resulting from any ideas or products referred to in the articles or advertisements.

Publisher’s Note: The opinions expressed in this supplement are those of the authors, presenters, and/or panelists and are not attributable to the sponsor or the publisher, editor, or editorial board of The American Journal of Managed Care. Clinical judgment must guide each professional in weighing the benefits of treatment against the risk of toxicity. Dosages, indications, and methods of use for products referred to in this supplement are not necessarily the same as indicated in the package insert for the product and may reflect the clinical experience of the authors, presenters, and/or panelists or may be derived from the professional literature or other clinical sources. Consult complete prescribing information before administering.

System Requirements
PC-based participants
Windows 7, Vista, XP, 2003 Server, or 2000

Macintosh®-based participants
Required: Mac OS X 10.4.11 (Tiger) or newer

© 2013 Managed Care & Healthcare Communications, LLC

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