Through this review , we found two key health system barriers to effective T2DM care and management : financial constraints faced by the patient and limited access to health services and medication .
This review points to the importance of reducing , or possibly eliminating , out-of-pocket costs for diabetes medication and self-monitoring supplies .
BACKGROUND Type 2 Diabetes Mellitus ( T2DM ) is reported to affect one in 11 adults worldwide , with over 80 % of T2DM patients residing in low-to-middle-income countries .
Health systems play an integral role in responding to this increasing global prevalence , and are key to ensuring effective diabetes management .
We conducted a systematic review to examine the health system-level factors influencing T2DM awareness , treatment , adherence , and control .
Patient-centered outcomes of a value-based insurance design program for patients with diabetes.
Value-based insurance design ( VBID ) initiatives have been associated with modest improvements in adherence based on evaluations of administrative cl aims data . The objective of this prospect i ve cohort study was to report the patient-centered outcomes of a VBID program that eliminated co-payments for diabetes-related medications and supplies for employees and dependents with diabetes at a large health system . The authors compared self-reported values of medication adherence , cost-related nonadherence , health status , and out-of-pocket health care costs for patients before and 1 year after program implementation . Clinical metrics and satisfaction with the program also are reported . In all , 188 patients completed the follow-up evaluation . Overall , patients reported a significant reduction in monthly out-of-pocket costs ( P<0.001 ) , which corresponded to a significant reduction in cost-related nonadherence from 41 % to 17.5 % ( P<0.001 ) . Self-reported medication adherence increased for hyperglycemic medications ( P=0.011 ) , but there were no apparent changes in glycemic control . Overall , 89 % of participants agreed that the program helped them take better care of their diabetes . The authors found that a  VBID program for employees and dependents with diabetes was associated with self-reported reductions in cost-related nonadherence and improvements in medication adherence . Importantly , the program was associated with high levels of satisfaction among participants and strongly perceived by participants to facilitate medication utilization and self-management for diabetes . These findings suggest that VBID programs can accomplish the anticipated goals for medication utilization and are highly regarded by participants . Patient-centered outcomes should be included in VBID evaluations to allow decision makers to determine the true impact of VBID programs on participants
Through this review , we found two key health system barriers to effective T2DM care and management : financial constraints faced by the patient and limited access to health services and medication .
This review points to the importance of reducing , or possibly eliminating , out-of-pocket costs for diabetes medication and self-monitoring supplies .
BACKGROUND Type 2 Diabetes Mellitus ( T2DM ) is reported to affect one in 11 adults worldwide , with over 80 % of T2DM patients residing in low-to-middle-income countries .
Health systems play an integral role in responding to this increasing global prevalence , and are key to ensuring effective diabetes management .
We conducted a systematic review to examine the health system-level factors influencing T2DM awareness , treatment , adherence , and control .