For People With Diabetes, the Most Expensive Medication Could Be the One Not Taken

BLOOMFIELD, Conn., Dec. 13, 2005 /PRNewswire/ -- Through a pilot study of members with diabetes, CIGNA Pharmacy Management (CPM) proved the importance of taking medications according to nationally established clinical guidelines. The participants in the New York Tri-State area pilot, who took their medications appropriately, lowered their blood sugar levels and had 13 percent fewer emergency room visits and 18 percent fewer hospitalizations than in the six months prior to their participation in the pilot program. The recently completed Diabetes Outcome Improvement Pilot Program also resulted in a 24 percent reduction in medical costs for members who achieved their recommended blood sugar goals.

Because the pilot program was so successful, the Diabetes Outcome Improvement Program has now been implemented nationwide. In addition to monitoring glucose levels, members in the national program who have high blood pressure, low kidney function or high cholesterol are monitored for medication compliance for those conditions as well.

Members in the pilot program for whom CPM could document a blood glucose level reduction were able to reduce their HbA1c blood glucose level by 1.4 percent on average. According to the United Kingdom Prospective Diabetes Study (UKPDS), the largest and longest study of type 2 diabetes performed to date, each one percent reduction in blood glucose level may reduce the risk of complications such as kidney failure, heart attack, blindness or amputation by 35 percent.

"A 1.4 percent reduction could correlate to as much as a 49 percent decrease in the risk of related complications. In addition, we found that 69 percent of the individuals identified in our program were being treated for one of the complications related to their diabetes. These complications are the leading cause of kidney transplants, blindness, and amputations in the country," said Thom Stambaugh, chief pharmacy officer for CPM. "The average cost of a heart attack is $25,000, kidney dialysis costs $60,000 a year, and the average kidney transplant is $210,000. Therefore, we are not only helping our members avoid these life altering events, but we are dramatically decreasing the cost of their health care."

In the pilot program, medical, pharmacy and lab claims data was used to identify members who were not reaching recommended long-term blood glucose levels. CPM then reviewed medication utilization patterns to determine if that might be contributing to higher than desirable blood glucose levels. The presence of more than one related illness including hypertension, kidney disease, or high cholesterol was also identified. The physicians for the members participating in the pilot were then sent information on each member, including lab data, medication utilization and hospital or emergency room visits, as well as recommended treatment goals for the member. The physicians were encouraged to review the information and consider whether adding or changing therapy would help the member achieve treatment goals. Members were re-evaluated every six months. The importance of reaching or progressing towards treatment goals was stressed at each subsequent contact with the members' physicians.

The CPM provider-focused diabetes program complements the CIGNA Well Aware for Better Health(R) diabetes disease management program which provides members with self-care information and support from a nurse coach to help them better manage their condition. The pharmacy management program included physician outreach for members enrolled in the Well Aware program as well as those who were not.

Almost 21 million people in the United States suffer from diabetes and another 41 million people are estimated to have pre-diabetes, a condition that increases the risk of developing type 2 diabetes -- the most common form of the disease, according to a report issued in October 2005 by the Centers for Disease Control and Prevention. Although those who already have diabetes represent only seven percent of the population today, according to an article in the October 8, 2003, issue of the Journal of the American Medical Association (JAMA), that number is expected to increase to 33 percent of all Americans born in the year 2000(1). "This is a growing problem that is not going to go away without serious intervention, which is why programs like this are so important," concluded Stambaugh.

CIGNA Pharmacy Management (CPM) refers to various operating subsidiaries of CIGNA Corporation (NYSE: CI) . Products and services are provided by these subsidiaries and not by CIGNA Corporation. These subsidiaries include Connecticut General Life Insurance Company, Tel-Drug, Inc., Tel-Drug of Pennsylvania, L.L.C., and HMO or service company subsidiaries of CIGNA Health Corporation.

(1) K.M. Venkat Narayan, MD, CDC Chief of Diabetes Epidemiology. JAMA.

2003, Oct 8;290(14):1884-90

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