Tackling the Diabetes Dilemma Through Prevention

Jan 29, 2019

With 1 in 3 adults in the U.S. considered prediabetic, the time is now to offer at-risk patients a pathway to a healthier lifestyle. Express Scripts’ enhanced Diabetes Care ValueSM does just that.

Member Diabetes Monitoring Header

With more than 30 million people in the U.S. living with the condition, diabetes is the #1 costliest traditional therapy class. In addition, 1 in 3 adults in the U.S. are considered prediabetic. These are alarming statistics for a serious condition that is the 7th leading cause of death in the U.S. and costs the healthcare system $327 billion per year.

Behavior-Based Diabetes Prevention

Express Scripts’ Diabetes Care ValueSM program (DCV), part of the SafeGuardRxSM platform, was specifically designed to tackle this diabetes dilemma. We’re now adding enhancements to the program, which will not only help diabetes patients manage their condition, but it will also provide support to help those with prediabetes – before they progress to a diagnosis.

Unlike many health conditions, diabetes is managed mostly by the patient, with support from a health care team. Healthy eating and exercise plays an important role in helping to control blood sugar. The same is true for diabetes prevention. According to the Centers for Disease Control and Prevention, a person’s risk of developing type 2 diabetes can be lowered by as much as 58% with healthy lifestyle changes through a specialized program.

By providing patients with holistic support and education, we can drive better health outcomes and lower costs for an even larger part of the population.

Beginning March 1, 2019, we will use rigorous data analytics and clinical insights to identify patients who, without the right intervention, are on a path toward a diabetes or cardiovascular disease diagnosis.

To help them avoid such a diagnosis, we will invite these members to participate in a 12+ month virtual program that encourages a healthier lifestyle. The personalized program includes:

  • Lifestyle coaching from registered dieticians, nutritionists and exercise physiologists
  • Clinical expertise and medication counseling from our Therapeutic Resource CenterSM specialized care teams
  • A cellular-connected scale for easy tracking of progress and trends
  • Access to a comprehensive, evidence-based lifestyle change curriculum
  • Peer support through a virtual community of individuals on their own journeys to better health

These enhancements build on a program that has had great results in tackling the diabetes dilemma. Through DCV, patients receive one-on-one support from specialist pharmacists and engagement tools to drive better health. Our efforts are working:

  • In 2017 alone, the program delivered $42.6 million in client savings and reduced per member per year costs by nearly $360.
  • One-on-one, holistic support from specialist pharmacists helped an additional 15% of enrolled patients at risk for heart attack or stroke start statin therapy. 2
  • If all Express Scripts plans were to similarly increase statin use among their diabetes members for better cholesterol control, we estimate that nearly 13,000 heart attacks would be prevented over the next 10 years.

Only Express Scripts has the insights, scale and tenacity to effectively identify patients with the highest risk of developing these chronic conditions and guide them toward a healthier lifestyle.

Author Bio

Lab Staff
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