ABSTRACT
Disease management (DM) programs refer broadly to programs that seek to improve the care of patients with specific chronic diseases by complementing their usual primary and specialty care with some variety of additional services. DM programs typically target high-risk or high-cost patients; emphasize clinical practice guidelines; employ telephone support to monitor and motivate patients; and aim to be cost-effective by reducing costly complications, hospitalizations, or emergency visits. Pharmacoeconomic (PE) approaches have been applied to DM programs and to component interventions – largely through observational studies offered by health plans, DM vendors, and academic researchers – but the reliability and validity of many of the studies have been questioned. This chapter outlines how PE principles, discussed in detail elsewhere in this book, have been applied with respect to DM programs. The chapter begins with an introduction to DM and the characteristics of DM programs that make them unique in the context of economic evaluation. Next, the chapter examines different approaches and applications of PE principles in the context of DM programs. The final section of the chapter discusses challenges, such as allowing a sufficient time horizon for improvements, the turnover of subjects within the program, defining the population and the denominator, that are inherent to integrating these disciplines as the field moves from theory to practice.
