The Cost of Diabetes

Assessing Gaps in Diabetes Care

The cost of treating diabetes is high and is ever-rising. Between 2007 and 2017, the economic cost of treating this chronic illness increased by 60%. In the US, $1 out of $4 in healthcare costs is spent on caring for people with diabetes. 

While $237 billion goes to direct medical costs annually, $90 billion out of the $237 billion is lost to reduced productivity. Furthermore, Americans aged 65 years and above account for 61% of the diabetes costs, primarily paid by Medicare. 

A significant percentage (48%-64%) of the total costs a person with diabetes spends in their lifetime are on diabetes-related complications, for instance, stroke and heart disease.

Why is some diabetes uncontrolled?

One may have uncontrolled diabetes for a range of reasons. Even those who use insulin and adhere to all medical advice occasionally have high blood sugar levels. In these circumstances, a doctor will have to modify their course of therapy or issue new prescriptions.

Additionally, according to data from the Centers for Disease Control and Prevention, 37.3 million adults in the United States had diabetes in 2019. At least 8.5 million of them didn’t have a diagnosis. A 2011 study also suggests that at least 2.4% of diagnosed persons may not get treatment.

This could stem from poor mental health, a lack of familial support, financial constraints, or membership in historically underrepresented groups that face unfair access to healthcare.

Proper diabetes management to lower cost and morbidity

Appropriate diabetes management can delay comorbidities and lower associated mortality. That is why payers insist on early diagnosis of diabetes mellitus. Over the years, there has been an overall improvement among adult Americans living with diabetes regarding managing their cholesterol levels and blood pressure. 

However, the reality for many others living with the disease is different, as diabetes management for them is far from ideal. Ultimately, improving the outcomes for these patients is a challenge for pharma and payers because of such barriers. 

Two of the most glaring barriers are provider adherence to recommendations and patient adherence to lifestyle modification and pharmacotherapy.

Outcomes chronic illness management solutions

The value of providing a diabetes management solution is ensuring that members are correctly managing their blood sugar and taking prescriptions, thus reducing the cost of diabetes care.

There is a dire need to manage costs while enhancing the quality of diabetes care and the overall population’s health. There is a gap in the market, and this has, for years, been a challenge. Consequently, several groups have emerged to customize diabetes management solutions, mixing and merging approaches mainly for members living with this chronic condition. 

One such provider is Outcomes, which aims to provide better outcomes for everybody. Outcomes was established with the sole purpose of unifying and building on proven, industry-leading solutions. Recently the brand has transitioned from mscripts™, OutcomesMTM™, and TelePharm™ to Outcomes.

The brand integrates tools to optimize pharma workflow and patient engagement programs. Outcomes clinical services are also integrated, providing a single ecosystem fashioned to strengthen connections across the healthcare sector to improve outcomes for diabetes patients.

Several groups have merged and mixed these approaches, primarily for members with chronic conditions. Through Outcomes, payers can implement regular touchpoints which empower their members to manage diabetes effectively. This is due to a better understanding of their condition and medication with qualified pharmacists. 

The payer can also undertake timely interventions to close member-specific drug therapy issues, optimize therapy, improve adherence and ultimately personalize the member journey.

Gaps in diabetes management

Both patients and healthcare professionals struggle to close knowledge, confidence, and educational gaps in managing chronic illnesses like diabetes effectively.

Despite the health system’s increasing dependence on community health management techniques to address a persistent rise in chronic illnesses, individuals still lack a proper understanding of caring for chronic disorders like diabetes and cardiovascular disease.

For patients, managing the difficulties of a chronic illness is hard. Even just learning that you have a chronic ailment can be extremely stressful, worrisome, and emotionally painful.

Common gaps & issues in diabetes management

• Members who don’t pick up the phone
• Rough user experience.
• Not personalizing care hence not catering to each member’s specific wants
• Failing to have a pharmacist on the care team.