Reflections on the Role of Pharmaceutical Companies in Disease Management Programs

Abstract

Disease management programs treat particular diseases in their entirety, directing patients and providers toward the most cost-effective interventions. Overall direction is provided by algorithms that suggest the best use of resources for critical points in the disease continuum, allowing early intervention to prevent costly crises. Clinical practice guidelines serve a similar role at the provider level by providing evidence-based suggestions for diagnosis and treatment. Additional disease management tools include patient and provider education programs, and sophisticated information systems to track interventions and outcomes and to feed information back to providers.

Pharmaceutical companies are aggressively marketing disease management programs. Initiatives have included creating disease management subsidiaries and purchasing pharmacy benefit managers. By targeting diseases such as asthma that are treated primarily with medications, the pharmaceutical companies and their subsidiaries risk creating a credibility problem with payers and providers. Large managed care organizations are particularly skeptical of proffered programs. Loath to share proprietary data, and viewing these proposals as little more than attempts to increase drug sales, they have resisted approaches. The pharmaceutical companies therefore view smaller, resource-poor managed care organizations and provider organizations as their primary target market.