Manage periodontal disease to rein in pharmacy costs

December 31, 2012

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.”