Emerging Type 2 Diabetes Treatment Strategies

Many patients with type 2 diabetes could avoid the long-term complications of their disease by ensuring consistent and proper glycemic control. With insulin use decreasing in recent years and the use of newer agents increasing, treatment regiments have changed drastically. Newer options may affect rates of glycemic control but may also be adding to the complexity of clinical decision making, as well as the management of benefits for plans and payers.

Many patients with type 2 diabetes could avoid the long-term complications of their disease by ensuring consistent and proper glycemic control. With insulin use decreasing in recent years and the use of newer agents increasing, treatment regiments have changed drastically. Newer options may affect rates of glycemic control but may also be adding to the complexity of clinical decision making, as well as the management of benefits for plans and payers. Managed Care Organizations can help play an important role in reducing overall healthcare costs for patients with type 2 diabetes by bridging the gap between what is recommended care and what is actual care.

One featured satellite symposium at the Academy of Managed Care Pharmacy (AMCP) 24th Annual Meeting, “Emerging Type 2 Diabetes Treatment Strategies: Practical Solutions for a Complex and Swiftly Changing Environment,” included the following distinguished panel of key opinion leaders: Susan Ann Cornell, PharmD, CDE, FAPhA, FAADE, assistant professor in the Department of Pharmacy Practice at Midwestern University Chicago College of Pharmacy; Lawrence Blonde, MD, FACP, FACE, director of the Ochsner Diabetes Clinical Research Unit; John M. Cruickshank, DO, MBA, CPE, Chief Medical Officer, Lovelace Health Plan; and James T. Kenney, Jr, RPh, MBA, Pharmacy Operations Manager, Harvard Pilgrim Health Care Inc.

Dr Cornell began by discussing the importance of treatment adherence and the effect nonadherence continues to have on the rising cost of healthcare by stating that “all of the knowledge we have does no good if the patient does not take their medication.” Dr Cornell also referenced a recent study in which researchers found that 50% of prescriptions are stopped within the first 6 months of treatment. This alarming finding is a significant problem for patients with diabetes when considering that the first 3 to 6 months of a new therapy is crucial for long-term adherence.

Dr Blonde also highlighted the obesity epidemic as related to diabetes, suggesting that most patients would require a combination of prescriptions as well as lifestyle intervention. Dr Cruickshank pointed out the rising prevalence of diabetes in the United States and the increasing importance this disease has on the overall national healthcare discussion; as A1c rises, so too does the total out-of-pocket costs for the patient. He emphasized the importance of value-based treatment.

Lastly, Dr Kenney discussed the value of comparative effectiveness research treatments for patients with type 2 diabetes, and other comparison tools (eg, Markov modeling vs other agents). He introduced a few disease-based pharmacoeconomic models designed to aid formulary decision making when long-term outcomes data are lacking.

For more information regarding the AMCP 24th Annual Meeting, please visit www.amcp.org.