HC4HR: Merck Promotes Quality and Value for Patients With Diabetes

When she spoke to us at the Health CEOs for Health Reform event recently, Merck's Senior Director of Public Policy, Jane Horvath, presented her response to two very important questions. Why does Merck, one of the world's largest pharmaceutical companies, believe that delivery system reforms are possible? And what has Merck done that demonstrates that change is possible?

To learn about Merck's pilot plan to promote value and quality in health care, check out the video below, or keep reading.

Better Diabetes Management

Earlier this year, Merck (a pharmaceutical company) and CIGNA (one of the largest health insurers in the U.S.) announced a partnership based around an innovative claim: they could lower costs while improving health care quality. If you've been following our other posts on the Health CEOs for Health Reform and what they've accomplished, this idea may sound familiar.

As a part of the deal, Merck agreed to offer Januvia and Janumet, two oral diabetes medications, at a discounted price if patients showed improvement while taking them. These drugs, in conjunction with diet and exercise, help patients to manage their blood sugar levels. If Cigna reviews the A1C lab results of patients with type 2 diabetes at the end of the year and find values have improved, Merck will increase the discounts on these drugs. (In a lab test, A1C levels can indicate a patient's average blood sugar levels over time.) This doesn't just apply to drugs produced by Merck. Any patient taking an oral anti-diabetic medication who shows improvement will trigger a discount for Cigna.

Comparative Effectiveness Research

Merck and Cigna's deal is performance based -- the better patients taking drugs do, the cheaper the pills. Adherence is a big deal for diabetics. Even the smallest slip up in following through with treatment can have serious health consequences down the road. Simpler (and cheaper!) prevention and disease management strategies such as exercise, diet, and taking medication on time can help protect diabetics from more serious (and costly) health complications such as heart or kidney disease, stroke, or nerve damage. Cigna told Reuters, "medicine adherence programs have helped diabetics reduce emergency room and other hospital visits by 50 percent for those reaching blood-sugar goals, and reduced diabetes-related costs by 24 percent."

According to Horvath, Merck decided a number of years ago that it should support comparative effectiveness research. CER is "an effective and rational tool and information set by which to optimize coverage policy and treatment decisions," said Horvath. By offering discounts on drugs that work, Merck is promoting a health care system that rewards quality, value, and well...health. In a press release, both Merck and CIGNA agreed that "aligning all of the incentives behind improving the health of individuals is one of the most effective ways to achieve long-term health improvement."