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But while some programs have been shown to save money for payers, widespread evidence of their economic impact is in short supply, according to a new study from Cornell University and Thomson Medstat

By Editor on Nov 15, 2005

But while some programs have been shown to save money for payers, widespread evidence of their economic impact is in short supply, according to a new study from Cornell University and Thomson Medstat which appeared in the summer issue of Health Care Financing Review.

In a review of 44 studies analyzing the return on investment of disease management programs, researchers found mixed results for programs focused on depression, diabetes and asthma, but positive impacts for programs targeting congestive heart failure and conditions of multiple illnesses.

In a study led by Ron Goetzel, director of the Institute for Health and Productivity Studies at Cornell University and vice president of consulting and applied research at Medstat, little conclusive evidence of measurable ROI from disease management was uncovered in most cases, simply because few economic analyses have been conducted.

Overall, there has been little scientifically rigorous research conducted to determine the financial impact of disease management, Goetzel says. That's a concern, because companies and governments have increasingly adopted disease management to control the cost of care for individuals with chronic medical conditions a minority of the population responsible for a majority of healthcare spending.

Goetzel says that although disease management programs can deliver significant health benefits, employers and health plans still need a sound business case to continue offering the programs.

In theory, disease management and intensive case-management programs offer health plans and employers opportunities to reduce healthcare costs and improve quality without resorting to restrictive utilization management or benefit reductions, he says.

But in practice, he stresses, programs must demonstrate cost savings if are to help slow rising costs.

Some programs, such as those targeting depression, he says, consistently cost more than they save in direct medical costs.

On the other hand, these programs may deliver a positive ROI if we factor in the impact on patient's day-to-day functioning, absenteeism and overall productivity, he adds.

But for pharmaceutical companies, says Eric Bolesh of Cutting Edge Information, the diversity and success of disease management programs will affect consumers's perceptions of pharma companies who often suffer from negative publicity. Effective, long-term programs, he says, will encourage patients to view these firms as healthcare partners rather than just drug manufacturers.

Constant communication, free of marketing language, is the most important aspect of a [pharma-sponsored] disease management program, says Bolesh. Many companies have launched magazines, cholesterol monitoring service, caloric intake calendars, e-zines and other health related services to regularly provide health information to consumers.

According to research by the Boston Consulting Group (BCG), although informed and in control patients are the most valuable targets for healthcare players seeking to influence treatment decisions, these patients also, surprisingly, are the most likely not to fill a prescription or comply with treatment regimens.

But these patients are active in researching their conditions and are the most heavily influenced by healthcare information they find on the Internet. Thus, the group says, these patients may be the easiest group to reach through compliance and disease management programs, particularly those that use Web-based or new technologies.

But BCG acknowledges that given the complexity involved in improving compliance effective programs often require a collaborative effort among the full spectrum of healthcare players. And that seems to be something pharmas are beginning to recognize, as evidenced by a new disease management program featured in today's companion article launched by a group of health advocates, physicians and a leading pharma company.

With disease management programs, pharma observers say, the industry has a collective chance to address some of its most pressing problems and opportunities by changing some of its push marketing tactics into value-added pull programs that benefit patients, physicians, payers and the pharmas themselves, and can elevate the industry to the status of true partner in the complete healthcare mix.