Impact of pharmacist intervention to improve medication access for patients with diabetes.

BACKGROUND: Despite newer guideline-recommended antidiabetic agents demonstrating a reduction of disease burden and improved health outcomes, high drug cost and restrictive insurance coverage limit public access. To address this issue, many manufacturers offer free medication through manufacturer patient assistance programs.

OBJECTIVES: This study aimed to determine the impact of pharmacist intervention using manufacturer patient assistance programs in individuals who are uninsured or enrolled in Medicare Part D prescription drug plan and to evaluate the impact of pharmacist utilization in meeting diabetic quality measures set forth by accountable care organizations (ACOs).

METHODS: This single-center, retrospective cohort study evaluated 171 participants enrolled into a manufacturer patient assistance program owing to pharmacist intervention compared with 171 participants receiving usual care. The primary outcome was the change in glycosylated hemoglobin (A1c) between groups. Secondary outcomes included the impact of pharmacist management on change in weight, change in blood pressure, and the number of participants meeting ACO quality measures.

RESULTS: The average change in A1c in the intervention group was -2.5% compared with an average A1c reduction of -1.3% in the control group (95% CI -2.11 to -1.67, P < 0.001). The average change in weight of the intervention group was -4.01 kg, whereas the control group had an average weight reduction of -1.4 kg from baseline (95% CI -3.95 to -1.61, P < 0.05). The body mass index (BMI) of the intervention group was a value of 1.4 kg/m2 lower whereas the BMI of the control group was 0.6 kg/m2 lower than at baseline (95% CI -1.38 to -0.61, P < 0.05).

CONCLUSION: Participants who were enrolled in a manufacturer patient assistance program by a pharmacist and were followed for diabetes care management experienced greater A1c lowering and weight loss than participants receiving usual care.