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Treatment plans for diabetes patients questioned Posted: March 19th, 2012

By Maryalene LaPonsie

A recent study issued by CVS Caremark finds physicians fail to consistently follow the recommendations of the American Diabetes Association (ADA). In 35 percent of cases reviewed, doctors did not adhere to the association's consensus treatment guidelines.

In addition to potentially impacting the quality of care, CVS Caremark says ignoring the guidelines can also result in increased health care costs for insurers and patients. The findings were determined through a review of the insurer's claims records.

ADA guidelines for diabetes patients

The ADA estimates 8.3 percent of the U.S. population has diabetes. In 2010, 1.9 million new cases were diagnosed in adults older than age 20. CVS Caremark says Type 2 diabetes - previously known as adult-onset diabetes - ranks as one of the most significant health issues worldwide. The insurer indicates the number of Americans with the disease is expected to increase 165 percent by 2050.

In reviewing the cases of more than 250,000 newly diagnosed diabetes patients, CVS Caremark says 35 percent of the cases did not follow ADA medication guidelines. The association recommends a first-line drug that is a generic. However, more than one-third of initial treatment regimens did not include this drug.

Increased medical insurance costs

CVS Caremark estimates that by not using the recommended generic medication, the health care system may be incurring an additional cost of $420 million annually. For those using the generic medication, the average pharmacy cost was $116.10 over a six-month period. When a more expensive therapy was chosen, the average cost for those six months jumped to $677.20.

"With approximately 2 million new cases of diabetes each year, if the medication patterns and insurance coverage for our cohort is representative of the U.S. population, an excess expenditure of $1,120 per patient per year would translate to more than $420 million in additional direct medication costs for diabetes therapy outside the established consensus guideline recommendations," said Niteesh K. Choudhry, the study's senior author, in a statement. "Because the prevalence of diabetes is increasing quite dramatically, the potential savings from improved adherence to these recommendations could far exceed these estimates."

The increased costs are not a concern for medical insurance companies only. Some health insurance plans charge a higher copayment for brand name prescriptions as compared to generics. Therefore, deviating from the ADA guidelines can result in higher costs for patients as well as insurers.