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Manage periodontal disease to rein in pharmacy costs
A study of 1.7 million patients with diabetes indicates that reducing inflammation of the mouth can produce improvement in other health measures.
A study of 1.7 million patients with diabetes indicates that reducing inflammation of the mouth can produce improvement in other health measures. By controlling periodontal disease, plan sponsors also save on medical and pharmacy costs.
The oral health study conducted last year by United Concordia Dental and parent company Highmark Inc. shows periodontal treatment for individuals with diabetes was associated with a significant decrease in hospitalizations and physician visits, delivering annual savings of $1,814 in medical care per patient per year. Likewise, the reduction in pharmacy costs averages $1,477 for diabetics who have gum disease and receive at least 7 treatments per year.
The study findings also showed that hospitalizations decreased by 33% per year and physician visits by 13% per year across the entire study population of diabetics when gum disease is treated and managed.
A United Concordia dental rider includes a value-based design that offers those with periodontal disease surgical and non-surgical treatments with no out-of-pocket costs. According to James Bramson, DDS, chief dental officer, in a covered population of 2,000 members, approximately 250 members might have diabetes. Of those, if just 6 receive periodontal treatment, the plan sponsor would recoup the cost of the rider.
“It’s enhanced coverage,” Dr Bramson said. “It takes the basic benefit that we have and adds additional features to the periodontal coverage for people who have chronic disease-in this case it’s diabetes.”
He said the health management program, UCWellness, will expand in the future to offer similar benefits to those with other chronic conditions.
Anthony Cannon, MD, endocrinologist; regional board president with the American Diabetes Assn., said periodontal disease occurs 2 to 4 times more often in patients with diabetes, and it is an indicator of poor glycemic control.
“The awareness is one thing,” he said, “the actual implementation of therapies is another.”
Coalition promotes important acetaminophen dosing reminders
November 18th 2014It may come as a surprise that each year Americans catch approximately 1 billion colds, and the Centers for Disease Control and Prevention estimates that as many as 20% get the flu. This cold and flu season, 7 in 10 patients will reach for an over-the-counter (OTC) medicine to treat their coughs, stuffy noses, and sniffles. It’s an important time of the year to remind patients to double check their medicine labels so they don’t double up on medicines containing acetaminophen.
Support consumer access to specialty medications through value-based insurance design
June 30th 2014The driving force behind consumer cost-sharing provisions for specialty medications is the acquisition cost and not clinical value. This appears to be true for almost all public and private health plans, says a new report from researchers at the University of Michigan Center for Value-Based Insurance Design (V-BID Center) and the National Pharmaceutical Council (NPC).
Management of antipsychotic medication polypharmacy
June 13th 2013Within our healthcare-driven society, the increase in the identification and diagnosis of mental illnesses has led to a proportional increase in the prescribing of psychotropic medications. The prevalence of mental illnesses and subsequent treatment approaches may employ monotherapy as first-line treatment, but in many cases the use of combination of therapy can occur, leading to polypharmacy.1 Polypharmacy can be defined in several ways but it generally recognized as the use of multiple medications by one patient and the most common definition is the concurrent use of five more medications. The presence of polyharmacy has the potential to contribute to non-compliance, drug-drug interactions, medication errors, adverse events, or poor quality of life.
Medical innovation improves outcomes
June 12th 2013I have been diagnosed with stage 4 cancer of the pancreas, a disease that’s long been considered not just incurable, but almost impossible to treat-a recalcitrant disease that some practitioners feel has given oncology a bad name. I was told my life would be measured in weeks.
