IMPACT OF PHARMACIST CONSULTATIONS PROVIDED TO PATIENTS WITH DIABETESON HEALTH-CARE COSTS IN A HEALTH MAINTENANCE ORGANIZATION

We conducted a study to assess the impact on healthcare utilization an d costs of pharmacist consultations provided to patients with diabetes . Data for this study were derived from a larger study conducted by Ka iser Permanente and the University of Southern California that evaluat ed three alternative models of pharmacist consultations (control, stat e, and Kaiser), Computerized data were available for patient demograph ic characteristics and healthcare utilization. We used medication data to classify patient cohorts as insulin only or oral antidiabetics +/- insulin, We estimated hospitalization costs based on diagnostic relat ed group and medication costs based on average wholesale price; office visits were estimated at $70 each, In the insulin only cohort, total costs for patients who had their prescriptions filled at a state model pharmacy were 7.8% less than those for patients filling prescriptions at a control model pharmacy (P = 0.008), In the oral +/- insulin coho rt, total costs for patients filling new prescriptions at a Kaiser mod el pharmacy were 21.9% less than those for patients using a control mo del pharmacy (P = 0.0001), The state model also was negatively correla ted (beta coefficient, -0.0997) with total costs (P = 0.0001), These d ata suggest that pharmacist consultations provided to patients with di abetes can decrease total healthcare costs in a health maintenance org anization.