INTERNATIONAL RESEARCH & OPINION

Regulatory and Healthcare News Should DM programmes be built or bought? Healthcare providers and payers who are deciding whether to build or buy disease management (DM) programmes should consider both economic and quality issues, according to various experts in the US. Al Lewis of the Disease Management Purchasing Consortium in Massachusetts considers that it is 'counterproductive' for independent practice association-model health maintenance organisations (HMOs) to build DM programmes. The resources spent on building a single DM programme could be used to purchase multiple DM programmes on a guaranteed-savings basis, he says. However, Dr Gray Ellrodt of APMlCSC Healthcare in New York state warns that buying DM programmes can be risky, in that DM companies may go bankrupt, and that the DM programmes they design may not operate from a clinical perspective.

Decision depends on disease? Dr Scott Weingarten from Cedars Sinai Health System suggests that it might be sensible to buy DM programmes for 'low-volume, relatively uncommon'· conditions such as congestive heart failure. However, it may be more practical to build DM programmes for conditions, such as hypertension, that require continuity of care. 'One could argue either way' for diabetes mellitus, he adds.

* in a commercial population

Buy vs. build debate boils down to weighing quality. savings issues. Disease Management News 3: 1 & 7. 25 Nov 1997 1OOO6l1OJ

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PharmacoEconomic8 & Ou1comes News 13 Dee 11197 No. 142

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