Healthcare Reform

A New Opportunity in Diabetes

June 09, 2010

Daniel M. Bradbury

Now that healthcare reform has been enacted, the nation will see a number of important changes over the next several years, including the expansion of health insurance to more than 30 million individuals who are currently not insured. As a leading innovator in the field of diabetes, Amylin believes we must now begin a new chapter in how we, as a nation, tackle the problem of chronic disease. Today nearly 24 million Americans are affected by diabetes. It is the third most expensive chronic disease to manage, costing more than $200 billion in direct medical costs and lost productivity. Nearly 10 percent of all healthcare spending goes to treat diabetes and its many serious complications, including heart and kidney disease, eye problems, circulatory disorders and emergency room visits. The National Minority Quality Forum estimates that 40% of all Medicare expenditures are spent on fee-for-services beneficiaries who are living with diabetes, up from 32% in 2000. Failure to reduce the prevalence of type 2 diabetes will have devastating consequences for patients suffering from the disease, as well as employers and the Federal government who will continue to pay more and more for the treatment of diabetes and its related complications. To do that will require four major priorities:

• First, we must engage in a renewed emphasis on prevention. Prevention in type 2 diabetes can be singularly effective. This means preventing the onset of diabetes through better nutrition and exercise, but also going beyond that and aggressively treating patients with pre-diabetes earlier in the disease progression, including utilizing the latest and most effective therapies. If we are able to identify the individuals at greatest risk and intervene effectively, we can slow the growth of the disease.
• We must concentrate our greatest efforts where the needs are highest. African Americans have double the risk of developing and dying from diabetes than do Caucasians. Latinos and Native Americans also have a higher-than-average burden. Effective educational and awareness programs in these communities could have a major impact on the health of the US population and our economy.
• We must screen, diagnose and treat diabetes more aggressively for the 24 million Americans who currently have the disease (including the approximately 6 million of those people who are undiagnosed). We must try to detect the disease earlier, understand how to slow its advance and prevent the complications that burden patients and the health system. The reform legislation includes authority to fund “demonstration projects” with more aggressive treatment paradigms, and these should move forward with a sense of urgency and a design that will allow for learning and adaptation.
• We must look at diabetes treatment as more than glucose control. A greater emphasis should be given on understanding how therapies not only control blood glucose, but also reduce cardiac and other complications. As these new findings emerge, healthcare practitioners and access groups should be educated on the new therapies and algorithms so that patients have broad access to the best tools available to effectively manage this disease.

Dan Bradbury is President and Chief Executive Officer, Amylin Pharmaceuticals.

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