The American Diabetes Association (ADA) and Genentech plan to launch a diabetes-fighting pilot program that takes aim at the lack of access to eye screenings in poorer communities.
The effort will kick off in Birmingham, Alabama, where the two will partner with African American community organizations in conducting focus groups in order to better understand what barriers exist to proper eye care. The pilot’s still mostly in the planning stages, though some information gathering has begun.
Sonali Chopra, executive director of patient advocacy relations at Genentech, told Fierce Healthcare in an email that Birmingham made sense as a place to start because it's a microcosm of the challenges the pilot aims to tackle.
“More than 500,000 people in Alabama have been diagnosed with diabetes and 68% of Birmingham residents are African-American,” Chopra said. “We see an opportunity to make an impact there based on the prevalence of diabetes in a community of color, as well as the ability to engage both urban and rural residents.”
Thorough eye exams play an important part in the prevention, early diagnosis and treatment of eye disease and vision loss caused by diabetes, yet many individuals in poorer communities either don’t receive or don’t have appropriate access to eye health care.
Diabetes is the leading cause of vision loss in people ages 18 to 64 years old. African Americans, American Indians, Alaska Natives, Hispanics/Latinos and older adults are at higher risk of losing their vision or going blind because of complications caused by diabetes.
“Diabetic eye disease is a leading cause of vision impairment—but it is preventable,” said Chopra. “Early detection and treatment of diabetic eye disease can reduce severe vision loss by 94%. Unfortunately, there are disparities in how different populations receive diabetes-related eye care and treatment. That’s why programs like this are so important, to help collectively address systemic inequities and improve eye health for all.”
Initially, the effort will focus on obtaining information from individuals with diabetes and providers to pinpoint what barriers may exist in getting equitable eye care. This will be done in small focus groups and may culminate in a larger summit. So far, ADA and Genentech representatives have met with physicians.
“While we are still working to identify specific community partners from a local health system, we will use these insights to design and execute a pilot program to help raise awareness of diabetic eye disease and access to screenings and care,” Chopra said. “Our initial work will focus on the African American community with potential to expand to other underrepresented groups.”
Diabetes represents a huge cost burden for employers, as a study earlier this month by direct healthcare company Nomi Health underscored. Direct healthcare delivers coverage to an organization, such as self-insured employers or labor unions, without using a go-between.
Nomi Health analyzed claims data for 500,000 individuals and found that diabetes costs employers about $245 billion a year: $170 billion in direct costs for treatment and medication and $70 billion for indirect costs such as disability, lost productivity and absenteeism.
An ADA study found that 1 in 4 healthcare dollars is spent on diabetes, and the organization estimates that the annual cost for treatment and care came to about $327 billion in 2017, the most recent estimate, which represents an increase from $245 billion in 2012.
The 2017 figure included $237 billion in direct costs and $90 billion in indirect costs.
Some employers have reacted by steering more employees into high-deductible health plans, but that can backfire, as a study in JAMA Network Open earlier this year concluded. Moving employees into HDHPs increases the odds that they will need to be rushed to emergency departments for severe hyperglycemia by 25%.
In addition, the odds of this happening increase by 5% for each year an employee is enrolled in a high-deductible plan.