Reduced Acute Diabetes Complications Linked to Preventive Drug List Benefits

By Susanne B. Haga, PhD


To improve medication adherence and health outcomes, some employers are offering a ‘preventive drug list’ (PDL) option with reduced out-of-pocket expenses for medications.  In Type 2 diabetes, like other chronic diseases, patients often take multiple medications to manage not only their blood glucose levels but also a constellation of other health problems such as hypertension and hypercholesterolemia. A newly published analysis in JAMA Health Forum by Frank Wharam and colleagues reports that PDL benefit plans can reduce acute complications in patients with diabetes. 

The research team analyzed data obtained from a large national commercial claims database between 2004 and 2017.  More than 10,000 PDL members with diabetes were 1:65 matched with non-PDL members. The primary outcome assessed was acute diabetes complications including bacterial infections, neurovascular events, acute coronary disease, and diabetic ketoacidosis, measured as complication days per 1000 members per year. The team found an 8.4 percent relative reduction in complication days in the PDL group compared with the control group.  PDL patients residing in lower income areas had a 10.2% relative reduction.

“The rising prevalence of high out-of-pocket cost health insurance can create substantial financial burdens for lower-income patients,” commented Wharam. “Preventive drug list plans offer reduced costs for many common medications, and we found that these pharmacy benefits are associated with reduced diabetes complications, particularly in the lower-income group.  Adopting these plans might be a relatively straightforward way for employers to improve the health of their workers and reduce costs associated with diabetes complications.”

Research has also demonstrated that PDLs can improve poor medication adherence driven by high medication costs.  With the disproportionate impact of diabetes on populations in low-income areas, PDL benefits should be considered as a viable option to facilitate access to necessary treatments and improve health outcomes. 


Citation:  Wharam JF, Argetsinger S, Lakoma M, Zhang F, Ross-Degnan D. Acute Diabetes Complications After Transition to a Value-Based Medication Benefit. JAMA Health Forum. 2024;5(2):e235309. doi:10.1001/jamahealthforum.2023.5309 [link]