Magazine article Drug Topics

PCS Institutes Disease Management Programs

Magazine article Drug Topics

PCS Institutes Disease Management Programs

Article excerpt

Just about every pharmacy benefit manager now says it has a disease management program, but what is it?

In describing new disease management programs offered by PCS Health Systems, Norrie Thomas, president of PCS' Clinical Services division (formerly, Clinical Pharmacy Advantage), a formulary manager based in Minneapolis, emphasized that its disease management programs are primarily an educational effort.

By coordinating the education of patients, pharmacists, and physicians as a team about how to best manage a patient's disease, the management of that patient's disease will improve--and that patient's health plan will see savings in health costs. she explained. Whether the programs are tied to a risk-sharing arrangement varies from client to client.

The first step in setting up a disease management program is to identify diseases that are appropriate for this sort of intervention, Thomas explained. Among PCS' choices are these: asthma, women's health, cholesterol, diabetes, depression, and ulcers.

The second step in developing a disease management program is to identify patients who are within the disease category, she continued. PCS currently identifies these patients through its pharmacy claims data. Patients who purchase certain kinds of drugs can be identified as having a certain disease, she said.

If it is possible to gather patient information also from physicians and other sources within a client's health plan, that information helps. Eventually, PCS' affiliation with an on-line medical communications network organization called Integrated Medical Systems (IMS) may prove helpful in gathering physician and other data useful to disease management.

For patients identified within different disease states, an educational program can be rolled out to help them better manage their disease, Thomas said. Targeted educational materials, including brochures, are sent to patients, their physicians, and their pharmacists. …

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