# DP20-002, Louisiana Experiment to Address Diabetes: Zero-Dollar Copayment (LEAD-ZDC) for Improving Disease Management

> **NIH ALLCDC U18** · TULANE UNIVERSITY OF LOUISIANA · 2024 · $457,508

## Abstract

Abstract
Type 2 diabetes mellitus (T2DM) remains a major public health concern in the United States, especially in
Louisiana where mortality from diabetes complications and cardiovascular disease (CVD) is high due to poor
diabetes management. Medication treatment non-adherence is prevalent and costly in diabetes management
where Cost-Related Non-adherence (CRN) with medication therapies has to be addressed as part of the social
determinants of health. We propose a Louisiana Natural Experiment Center (LNEC) that includes
academic/research institutions, payers, community non-profit organizations and community/patient partners,
and health systems to improve care for diabetes and reduce risk factors and complications. The LNEC will be
enhanced by the infrastructure of Research Action for Health Network (REACHnet). The LNEC's Louisiana
Experiment to Address Diabetes: Zero-Dollar Copayment (LEAD-ZDC) project will examine the policy
intervention of lowering out-of-pocket cost by ZDC for select medications (antidiabetics, antihypertensives, and
statins) among fully insured Blue Cross and Blue Shield of Louisiana (BCBSLA) members with T2DM. The
hypothesis is that the ZDC program will improve medication adherence and ultimately improve health
outcomes. The overall goal is to study how ZDC may reduce CRN, overall medication non-adherence, health
care utilization, and diabetes complications. The three specific aims will be evaluated according to the reach,
effectiveness, adoption, implementation, and maintenance (RE-AIM) framework. The first aim is to evaluate
how health impacts of the ZDC program improve the primary effectiveness measure: medication adherence
with ZDC list of antidiabetics and multiple secondary effectiveness measures such as overall medication
adherence, adherence with medications for risk factors (antihypertensives and statins), diabetes control,
complications, health care utilization, and patient-reported outcomes. The second aim is to evaluate the
barriers (e.g. racial/ethnic and rural/urban disparities) and facilitators related to the ZDC program in Louisiana.
The third aim is to estimate the cost-effectiveness of the ZDC program from health system and social
perspectives using modelling techniques. Patient and stakeholder engagement will be implemented as a
cornerstone of the LEAD-ZDC project, which will explore the barriers at patient, provider, health system, and
community levels, to inform, engage and empower patients, and to partner with and support T2DM patients to
achieve better health outcomes. The proposed study will generate urgently needed data on effective, practical,
and sustainable programs for eliminating health disparities and reducing diabetes-related disease burden. The
study findings will assist (1) patients with better access to needed medications, and (2) providers and payers
with improved understanding of how to address barriers to adherence so that they may better work with
patients to make medications affordable...

## Key facts

- **NIH application ID:** 10852790
- **Project number:** 5U18DP006523-05
- **Recipient organization:** TULANE UNIVERSITY OF LOUISIANA
- **Principal Investigator:** LIZHENG SHI
- **Activity code:** U18 (R01, R21, SBIR, etc.)
- **Funding institute:** ALLCDC
- **Fiscal year:** 2024
- **Award amount:** $457,508
- **Award type:** 5
- **Project period:** 2020-09-30 → 2025-09-29

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10852790

## Citation

> US National Institutes of Health, RePORTER application 10852790, DP20-002, Louisiana Experiment to Address Diabetes: Zero-Dollar Copayment (LEAD-ZDC) for Improving Disease Management (5U18DP006523-05). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10852790. Licensed CC0.

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