Reimagining diabetes treatment

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Managing diabetes can be complex. Achieving and maintaining one’s best health for this chronic condition, which causes higher than normal blood sugar levels, depends on a person’s ability to monitor symptoms, manage complicated medication regimens, control blood glucose and practice healthy behaviors.

“There are 50 different things — or maybe more — that a person with diabetes could be doing at any time to best manage their condition,” says Stella Wong, Senior Director for Product Development at CVS Health. “It's overwhelming.”
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In the U.S., more than 34 million people live with diabetes and deal with these challenges, according to the Diabetes Research Institute Foundation. And only about 23 percent of people with Diabetes have it under control, says Peter Simmons, RPh, Vice President of Chronic Care Optimization. “Given the array of solutions available, that's a shame. We feel like we can do better.”

To do that, CVS Health created a proactive, integrated and holistic plan that reimagines diabetes treatment for its members. The goal is to reduce the complexity of self-management and improve health outcomes for plan members with diabetes — while preventing its onset.

Available with Caremark and Aetna benefit plans, the Transform Diabetes Care program uses CVS Health data insights and analytics to create personalized care plans for individuals across five clinical areas. The plan can be communicated through local CVS pharmacists and HealthHUB® professionals, digitally and virtually. Members are provided myriad tools to support their personalized care plan.

Peter Simmons, Vice President of Chronic Care Optimization for CVS Health.
“We always seek to be consumer-centric, consider how to deliver care locally and make care as simple as possible for customers and patients,” says Peter Simon, CVS Health’s VP Chronic Care Optimization.

The data also allows CVS Health to identify gaps in care and respond to patient needs before they arise. This proactive approach sets it apart from most other treatment plans, says Kyle Smith, head of CVS Health Transformation Marketing. “I think that's the most compelling thing about the work that we're doing.”

The program also utilizes a Pharmacist Panel to help patients stick to their plans, says Pharmacy Services Market Support Coach Rebecca Rice. “Pharmacists continue the conversation with their patients about their health while building trust and rapport,” she says.

“We think about our purpose every day: how we can help people on their path to better health,” Simmons says. “We always seek to be consumer-centric, consider how to deliver care locally and make care as simple as possible for customers and patients, especially those managing chronic conditions such as diabetes.”

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Expanding precision oncology care

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Tech entrepreneurs talk as much about working “on their business” as working “in their business” — another way of saying that innovating is as important as working on the day-in and day-out needs for a business to succeed. While the daily demands of patient care take a majority of their focus, oncologists, like smart tech executives, see technological advances and innovative oncology therapeutics as essential to improving the patient journey.

Today’s health care environment includes expanding the use of precision medicine, genomics, and technology, as well as increasing access to appropriate treatments to help improve patient experiences and outcomes. 

Precision medicine and the role of genomics

The late Clayton Christensen, renowned author and Harvard Business School professor who wrote at length on “disruptive innovation,” noted that precision medicine could aid in driving down health care costs without compromising quality or outcomes. Oncology evidence-based guidelines have been shown to improve treatment, outcomes, and costs by quickly starting patients on the most effective treatment, often with fewer side effects and less treatment time.https://ascopubs.org/doi/pdf/10.1200/JOP.17.00091

CVS Health’s Divisional Head of Enterprise Oncology Dr. Roger Brito describes the company’s precision approach that employs disruptive innovation: “The critical period between diagnosis and starting on therapy is an incredibly stressful and scary time for a patient. The ideal situation is to formulate the optimum treatment plan and get the patient started on the appropriate therapy as soon as possible.” 

Still, with approximately 700 updates in 24 months across 59 different National Comprehensive Cancer Network (NCCN) treatment and supportive care regimens, and a 63 percent expansion in oncology drugs in development in the last decade (IMS Health, R&D Focus, IMS Institute for Healthcare Informatics, May 2016.), applying the most current therapies in daily practice is difficult for many oncologists.

“Keeping up with all of the changes in treatment, like the rapidly expanding oncology drug pipeline and evolving clinical guidelines for cancer treatment, can be very challenging for oncologists. 60% of community oncologists regularly use cancer pathwaysHigh-quality oncology clinical pathways are detailed, evidence-based treatment protocols for delivering cancer care to patients with specific disease types and stages. When properly designed and implemented, oncology pathways can serve as an important tool in improving care quality and reducing costs. https://www.asco.org/practice-policy/cancer-care-initiatives, so there is an opportunity to better support them in delivering the latest in cancer care,” says Brito.

On top of that, consider the exciting opportunity to enhance precision medicine with the latest genomics science and technology. “Identifying the genomic landscape of an individual patient’s tumor enables oncologists to treat the root cause specifically and more effectively,” says CVS Health’s Transformation Vice President for Complex Chronic Disease Anne Claussen.

CVS Health’s analysis suggests that broad-panel genomic sequencing may result in cost savings, and a pilot is underway that will explore this in depth.

With little debate over the efficacy of genomic testing, many wonder why 60 percent of advanced cancer care patients receive no genetic testing.https://www.foundationmedicine.com/blog/uncovering-insights-in-pancreatic-and-prostate-cancers “There are currently 125 approved cancer drugs and 86% of those in late-stage development that require genetic testing, yet few eligible patients receive a companion lab test. And even when advanced testing is administered, patients often receive the less comprehensive single gene mutation test, which does not provide a patient’s complete genetic profile,” says Claussen.

Testing a patient’s tumor, looking at DNA and RNA sequencing, and pairing that data with a patient’s health information is complicated and requires expertise in pharmacogenomics to interpret. Further, oncologists also need experience and training with such data to explain results to their patients. Here again, time is critically important to get the patient on the appropriate therapy as soon as possible.

Using technology to speed and expand support

CVS Health is building on its experience and bringing together capabilities across our health plan and pharmacy businesses to make precision medicine and genomics more accessible while easing adoption for oncologists with our Transform Oncology Care program.

Claussen stated, “We are proactively partnering with oncologists to develop and enhance our oncology care solutions by facilitating frequent, two-way feedback and providing reporting that highlights opportunities and gaps to improve health outcomes.”

CVS Health is helping oncologists employ broad-panel gene sequencing tests with the latest NCCN treatment and supportive care guidelines that help in the selection of the most precise and appropriate treatment regimen based on the patient’s clinical and genetic profile. Additionally, providers are notified of applicable clinical trials that their patients may qualify to participate in. “Here is where we see the power of precision medicine and evidence-based tools such as our Transform Oncology Care program, which allows providers to request an authorization online and receive approval within minutes. Patient anxiety is eased because they will get their treatment in a timely manner, and the provider’s process flow is streamlined, resulting in a much better patient experience,” explains Dr. Brito.

Transform Oncology Care strives to provide targeted strategies for every step of the cancer care journey.

Read the infographic.

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