Report Shows States are Pursuing Medicaid Cost Controls Without Monitoring Quality of Diabetes Care; Nov. is National Diabetes Month 11/4/2003
From: Sarah Gegenheimer of Health Strategies, 202-295-0124; Bronwyn Reynolds of the American Diabetes Association, 703-549-1500 ext. 1474 WASHINGTON, Nov. 4 -- As we begin National Diabetes Month, a new study shows that most state Medicaid programs are not equipped to monitor and evaluate the health impact that pharmaceutical cost containment measures are having on Medicaid diabetes patients. The new study, released today by the Health Strategies Consultancy in partnership with the American Diabetes Association (ADA) and the Duke University Medical Center, recommends that policymakers require evaluation activities when cost containment policies are enacted to help ensure that health is not jeopardized given the unique nature of the diabetes patient population. "As states grapple with growing budget crises, many state governments are implementing Medicaid pharmaceutical cost containment measures. The trouble is that states often lack the ability to measure what impact these measures are having on vulnerable populations, especially those with diabetes," said Dan Mendelson, President and Founder of Health Strategies. Diabetes is the sixth leading cause of death among adults. This chronic illness is one of the most expensive medical conditions, affecting approximately 8 percent of the U.S. adult population. The high prevalence of diabetes among minority populations coupled with the high percentage of minority Medicaid beneficiaries suggests that a disproportionate number of Medicaid beneficiaries suffer from diabetes. The report underscores that diabetes is a critical target for evaluating the effects of Medicaid pharmaceutical cost containment efforts on patient outcomes due to: 1) the prevalence of the disease; 2) the common occurrence of diabetes co-morbidities; and 3) the variety of pharmaceutical products associated with the disease. "Access to medications for patients with diabetes is a critical issue for the long-term health of these patients. Diabetes is a great example to assess our stewardship of these state programs since the effectiveness of our treatment can be readily assessed from a simple blood test," said Kevin Schulman, M.D., Professor of Medicine at Duke University Medical Center and a co-author of this report. Health Strategies and the Duke University Medical Center surveyed states that had implemented preferred drug lists (PDLs) - mechanisms states have adopted to emulate commercial formularies. They found that most states do not currently collect clinical outcomes data for populations affected by pharmaceutical cost containment policies, or, alternatively they are not making these data available to researchers in a confidential way. Of the states reviewed, only Washington was found to be collecting data on Medicaid diabetes patients and interested in making the data available for study. "State lawmakers must keep the needs of diabetes patients in mind before they enact pharmaceutical cost containment measures," said Michael Mawby, National Vice President, Government Relations and Advocacy, American Diabetes Association. "This review documents the tremendous impact and harm that poorly designed Medicaid cost containment programs can have on patients with diabetes. Rather than inadvertently jeopardizing the care of diabetes patients, states should only construct cost containment programs that benefit patients living with diabetes." "It is my hope that states will turn to us for help in designing programs to reduce the incidence and risk of diabetes complications like heart disease, stroke, blindness, kidney failure and amputations," Mawby added. "The American Diabetes Association believes that a focus on reducing diabetes complications will save more resources for states than poorly designed cost containment programs that will only increase the burden of diabetes in the long run." About The Health Strategies Consultancy LLC Health Strategies is a Washington-based health policy think tank and strategic consulting firm that focuses on the commercialization of new medical technology. The firm's diverse client base includes Fortune 500 health care technology companies, Federal Government agencies and major medical foundations. Its team includes health care specialists with unparalleled expertise in pharmaceutical and medical device policy, with collective experience spanning the White House, the U.S. Office of Management and Budget (OMB), the U.S. Department of Health and Human Services (HHS), and the U.S. Congress. Additional information about Health Strategies is available on our website at http://www.healthstrategies.net. About the American Diabetes Association The American Diabetes Association is the nation's leading voluntary health organization supporting diabetes research, information and advocacy. The Association's advocacy efforts include helping to combat discrimination against people with diabetes; advocating for the increase of federal diabetes research and programs; and improved access to, and quality of, healthcare for people with diabetes. Its mission is to prevent and cure diabetes and to improve the lives of all people affected by diabetes. Founded in 1940, the Association provides services to hundreds of communities across the country. For more information please call the American Diabetes Association at 1-800-DIABETES (1-800-342-2383) or visit http://www.diabetes.org. Information from both these sources is available in English and Spanish. ------ The full text of the diabetes report is available upon request. |