The Diabetes Ten City Challenge is an innovative diabetes self-management program conducted by the American Pharmacists Association (APhA) Foundation through HealthMapRx™
, with support from GlaxoSmithKline.
Through the DTCC, 30 employers in 10 cities established a voluntary health benefit for employees, family members and retirees with diabetes and provided incentives such as waived co-pays for diabetes medications and supplies if participants met regularly with specially trained pharmacists to manage their medications, monitor key diabetes indicators and control their diabetes through diet, exercise and other lifestyle changes.
Charleston/Spartanburg, S.C.; Cumberland, Md.; Chicago, Ill.; Colorado Springs, Colo.; Dalton, Ga.; Honolulu, Hawaii; Los Angeles, Calif.; Milwaukee, Wis.; Pittsburgh, Pa.; and Tampa Bay, Fla.
Final aggregated data for 573 participants was published in the May/June 2009 issue of the Journal of the American Pharmacists Association (JAPhA).
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 14.8 months, show patients saved an average of $593 per year on their diabetes medications and supplies because employers waived co-pays to encourage people to participate in the program.
Economic outcomes of the DTCC were measured in a manner consistent with previous employer-based cost analyses published by the APhA Foundation. Projections were calculated based on trend data in two recent studies: the 2008 AON Consulting Worldwide health care cost survey of more than 70 leading healthcare insurers (published in August 2008) and the economic projections of the U.S. Federal Reserve System's Federal Open Market Committee (FOMC) published in its January 2008 economic summary.
People with diabetes who were in the program an average of 14.8 months showed significant improvements in clinical measures including hemoglobin A1C (blood glucose), LDL cholesterol and blood pressure. There was a 23% increase in the number of participants achieving the American Diabetes Association goal of <7; an 11% increase in the number of participants achieving National Cholesterol Education Goals; and a 39% increase in the number of participants with a combined diastolic/systolic goal achievement of 130/80.
The percentage of participants with current flu vaccines increased from 32% to 65%; those with current eye exams increased from 57% to 81%; and those with current foot exams increased from 34% to 74%.
The results prove that the DTCC collaborative care model is effective for managing diabetes and replicable in diverse locations and employers.
In early 2009, the APhA Foundation announced it would offer the DTCC collaborative care model to employers nationwide for diabetes and other chronic diseases through HealthMapRx.
HealthMapRx offers consumer incentive programs that focus on patient self-management education and techniques to help patients with chronic conditions improve health outcomes. The HealthMapRx programs match patients to community pharmacist "coaches" who provide hands-on education, monitoring, and evaluation of health improvements. With over 80 employer sponsored health plans, the program assists thousands of patients throughout the country.
According to APhA Foundation CEO William M. Ellis, our nation's health care system is broken. Ellis said programs like the DTCC and HealthMapRx provide an opportunity to transform health care delivery in local communities and drive fundamental change in the U.S. health care system by encouraging employers to invest in helping their employees manage all chronic conditions, reducing health care costs and improving patient outcomes.