Managed Care - February 2009 - (Page 40) Effect of Drug Therapy on HEDIS Measurements of HbA1c Control In Diabetes Patients Gary Bazalo, MS, MBA1; Richard Weiss, MS1; Nathaniel Clark, MD2; Berhanu Alemayehu, PhD3; Felicia Forma3; Garrett Ingram ME3 Managed Solutions LLC, Mount Freedom, N.J.; 2Senior Medical Adviser for Diabetes, Novo Nordisk Inc., Princeton, N.J. ; 3Health Economics & Outcomes Research, Novo Nordisk Inc., Princeton, N.J. 1 INTRODUCTION The National Committee for Quality Assurance (NCQA 2008) collects data from over 90 percent of the health plans in the United States to evaluate and report health plan performance with respect to quality of care and service.The tool that NCQA uses to collect this data is the Health Plan Employer Data and Information Set (HEDIS) (NCQA 2007, NCQA 2005). HEDIS addresses a wide range of important health care states, including comprehensive diabetes care. Comprehensive diabetes care data collected by HEDIS and reported annually by NCQA are used by employers, providers, and consumers to compare health plans’ care Key Words: HEDIS, diabetes care, analog insulin, human insulin ABSTRACT The purpose of this study was to corroborate an earlier study that explored the relationship between a health plan’s Health Plan Employer Data and Information Set (HEDIS) score for glycolated hemoglobin (HbA1c) control in diabetes patients and its utilization of insulin and oral diabetes products. Prescription volumes were tracked for four categories of diabetes drug therapy: analog insulin, human insulin, single-source brand oral products, and multisource generic oral products, for calendar years 2005 and 2006. The prescription shares of each of the four drug categories for each health plan were matched to the health plan’s HEDIS measurements of HbA1c control for each year. Univariate and multivariate regression analysis was performed between the health plan’s HbA1c -based HEDIS score and its prescription share of each drug category. A favorable and statistically significant (p 9 percent (NCQA 2007). There has been a continual improvement in the percentages of patients in poor diabetic control from a high of 42.5 percent in 2000 to 29.6 percent in 2006, the most recent year for which data is available. Recently, NCQA has added a new measure of performance with respect to diabetes. “Good HbA 1c Control” will report the percentage of patients with diabetes with HbA1c <7 percent. The most recent NCQA report stated that 41.8 percent of the population with diabetes is reported to be within good control as defined by this new measure (NCQA 2007). Attempts have been made to correlate disease management, adherence, and preventative care programs with improvements in diabetes HEDIS scores. While some of these studies have shown an improvement in HEDIS scores, others have demonstrated inconsistent results (Sidorov 2002, Bramley 2006, Quenan 2000). In 2007, we reported a correlation 40 MANAGED CARE / FEBRUARY 2009
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