Patient education and self-management

Although it may be difficult or uncomfortable to talk about the costs of treatment, it has a great impact on medication adherence and overall treatment satisfaction. In this case, in addition to discussing insurance coverage and what she can afford, you should also talk with the patient about ways the cost of her medications might be reduced.

While no generic formulations are available for exenatide, liraglutide, saxagliptin, or sitagliptin, each manufacturer offers a prescription assistance program. Patients should also be encouraged to check manufacturers’ Web sites for available coupons or discount programs.

With this patient, you also might talk about how different medications can affect total cost of her diabetes treatment differently. Limited retrospective analyses suggest that compared with glimepiride, liraglutide reduces the total cost of care, including care for ocular events and neuropathy leading to amputation.¹³ Other studies indicate that the overall cost of care with exenatide is lower than with insulin glargine,¹⁴ including care for hypoglycemia-related events.¹⁵

Summary

Working closely with patients and providing ongoing education, ideally in conjunction with a diabetes care team, can help ensure that the best treatment options are selected for an individual patient and that the patient is capable of effective self-management.