A descriptive study of patients receiving foundational financial assistance through local specialty pharmacies.

OBJECTIVES: To describe the population of patients who received financial assistance from the Good Days Foundation (GDF) as facilitated by Walgreens local specialty pharmacies (LSPs). STUDY DESIGN: This was a retrospective descriptive study. METHODS: This study used a joint foundational and pharmacy claim database between January 1, 2014, and December 31, 2016. RESULTS: Among 1572 eligible patients who received GDF financial assistance as facilitated by Walgreens LSPs, 1524 had disease state information and 14 of these patients receveived financial assistance for 2 disease states (patient count denominator, 1538). The top 3 disease states by patient count were oncology (1403; 91.2%), multiple sclerosis (49; 3.2%), and hepatitis C (39; 2.5%). Of the 777 patients who had complete data and disease state information, 2 received finanical assistance for 2 disease states (denominator, 779); oncology remained the disease with the highest patient count (724; 92.9%). The mean annual financial assistance per patient was highest for hepatitis C ($4156), followed by oncology ($3603) and miscellaneous/rare disease ($1829), which covered 98.8%, 99.3%, and 99.6% of these patients' total co-pay requirements, respectively. In addition to prescription co-pay assistance, 21 patients received travel assistance of $554 per year per patient from GDF. The mean persistence of oncology patients was 170.7 days without a 30-day gap over 1 year of observation time. CONCLUSIONS: The facilitation of treatment by GDF and Walgreens LSPs may be the key to many patients receiving their treatment and maintaining medication persistence. GDF co-pay assistance helped cover most out-of-pocket costs associated with medications and aided with travel expenses for patients, especially in the area of oncology. For many patients, this meant reducing the significant financial barriers to accessing care and facilitating the necessary treatment for their chronic or life-altering disease. Without this assistance, many patients would simply not have been able to meet the expected medication persistence and thus would have received suboptimal treatment.

Accuracy of Capillary Hemoglobin Measurements for the Detection of Anemia among U.S. Low-Income Toddlers and Pregnant Women.

The aim of this study is to evaluate the accuracy of capillary hemoglobin (Hb) measurements in detecting anemia among low-income toddlers (aged 12-35 months) and pregnant women. In analyses of data among toddlers from Kansas City (n = 402) and St. Louis, Missouri (n = 236), and pregnant women at <20 weeks gestation from Cleveland, Ohio (n = 397), we compared subjects' anemia status based on capillary Hb concentrations in finger puncture samples as measured by the HemoCue system with their anemia status based on venous Hb concentrations as measured by the HemoCue and Coulter Counter. The sensitivity of capillary blood analyses in identifying cases of anemia was 32.8% (95% Confidence Intervals (CI): 21.0%-46.3%), among Kansas City toddlers, 59.7% (95% CI: 45.8%-72.4%) among St. Louis toddlers, and 66.7% (95% CI: 46.0%-83.5%) among pregnant women in Cleveland; the corresponding specificities were 97.7%, 86.6%, and 96.7%, respectively. The correlation between HemoCue and Coulter Counter measurements of venous Hb (0.9) was higher than that between HemoCue measurements of capillary and venous blood (0.8). The results show that Hb measurements of capillary blood with HemoCue were not optimal for determining the anemia status of toddlers and pregnant women.

The Impact of a Worksite-Based Diabetes Prevention Intervention: A Pilot Study.

The purpose of this study was to assess the impact of a program to prevent the development of type 2 diabetes among participants with prediabetes. The program focused on a healthy eating style, behavior modification, daily physical activity, and achieving a healthy weight. This was a retrospective observational analysis of a pilot program designed to prevent diabetes among employees with prediabetes. This intervention involved 12-16 weeks of nutrition counseling with the registered dietitian and participation in physical activity of at least 150 min/week. The primary outcome for this study was the prevention of type 2 diabetes. Secondary outcome measures included changes in the following biometrics: body mass index (BMI), systolic blood pressure (SBP), diastolic blood press (DBP), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), total cholesterol, waist circumference, and triglyceride levels. The diabetes prevention intervention was associated with significant improvements in glucose (-6.6%), A1c (-2.9%), weight (-5.5%), BMI (-5.5%), SBP (-4.9%), DBP (-3.9%), total cholesterol (-5.0%), LDL-C (-7.0%), and triglycerides (-13.9%). After the 12-16-week intervention, the prevalence of prediabetes was reduced by 31% by fasting blood glucose or A1c levels. Baseline A1c, baseline glucose level, age, and number of sessions attended were all significant predictors of the odds of transitioning out of the prediabetes stage, controlling for all other covariates in the model. This pilot study suggests that the implementation of a worksite diabetes prevention intervention can help employees transition from a prediabetes status to no risk of diabetes.