Pfizer and Haringey Teaching Primary Care Trust (TPCT) have launched a joint project to help patients with coronary heart disease, congestive heart failure and diabetes to manage their condition better.

The 12-month pilot programme in the London borough is intended to produce measurable health improvement in around 600 enrolled patients, helping them take greater control of their conditions and make best use of NHS services.

The programme will be assessed on a regular basis to ensure it is meeting four basic objectives:

• Patient satisfaction with the programme
• Acceptance by healthcare workers
• Clinical outcomes
• Improvements in the process of care

Pfizer says the programme does not cover any agreement on the prescribing of its drugs, which will remain in the hands of NHS professionals.

Spokesman for the company Roy Sutherwood stressed: "There is no quid pro quo in this agreement,but added: "If you are as confident in your products then yes, of course, there should be commercial benefits."

The new programme bears some resemblance to the well-established practice of pharma companies paying for nurses to work in a general practice to identify and diagnose patients with a given condition. Like this practice, Pfizer scheme is likely to increase identification of high-risk patients and produce more diagnoses, helping the PCT meet its health targets and also boost the company sales in the area.

The £250,000 project is jointly funded by Pfizer and NatPaCT, the primary care modernisation unit, and is part of its wider 'Transformational Change Programme' for PCTs aimed at re-designing services around patients with chronic conditions.

Four care managers, hired and trained specifically to run the programme will educate patients enrolled in the scheme and will use care management technology tools developed by Pfizer Health Solutions, a subsidiary of the pharmaceutical company.

The care management system has been customised to reflect Haringey service guidelines, and will be used to reinforce recommendations and treatments prescribed by GPs.

David Sloman, chief executive of Haringey TPCT said: "The programme is another step on the way to providing excellent patient-centred care to Haringey residents. Bringing together the knowledge and expertise of the clinical staff, working in local general practices and hospitals alongside the knowledge and expertise of Pfizer gives us a major new opportunity to improve the care that we offer to people with chronic illnesses."

The initiative has parallels with a raft of other schemes around the country, including a growing number of 'Expert Patient' programmes, which are to be rolled-out across the UK over the next three years, although these do not involve the pharmaceutical industry directly.

In the US, the concept of 'disease management' is well established. In particular, Pfizer has been pioneering a collaboration with the Florida state healthcare system, similar to the Haringey project which it says has produced significant improvements for patients.

Over 113,000 patients were enrolled in the Florida programme in May last year, and were given education and simple self-diagnosis tools such as blood-pressure cuffs, scales, and peak flow meters.

Pfizer says 48% of hypertension patients succeeded in lowering their blood pressure while a huge increase in the use of peak flow meters saw a 34% improvement in severe asthma patients.

The Haringey pilot's impact will be assessed in the same way as other schemes in NatPaCT's national programme. Patient satisfaction, changes in patient behaviour relating to health, clinical outcomes, use of healthcare services and improvements in how the services are delivered will all be monitored.

Clinicians, managers and patient representatives will all be invited to contribute to the development of the Haringey project, which will be overseen by a formal collaborative structure.

A project board, a medical advisory board and a project team will be established and will be made up of representatives from Haringey TPCT, Pfizer and Whittington and North Middlesex Hospitals. The partners say it will ensure the project is 'objectively evaluated' from its launch this April to its planned finish in June 2005. Commenting on the Haringey scheme, Pfizer UK managing director Dr Olivier Brandicourt, said: "Improving the quality of life for Haringey patients lies at the heart of this partnership.

"Providing this kind of personalised education and support enables them to become more active partners in their own healthcare. Pfizer has an eight-year history of success in managing this type of technology-based approach and together with our partners, we aim to improve the quality of life of people suffering from chronic diseases. We hope to see this programme expand over time to potentially reach organisations, affiliated GPs, and patients across the UK."

Pfizer is the biggest pharmaceutical company in the world, and is also number one in the UK, where its dominance is underpinned by a strong cardiovascular portfolio. The company will add to that with the launch of Caduet its combination of cholesterol-lowering Lipitor with hypertension drug Norvasc expected later this year.

Many diabetes patients suffer from cardiovascular problems and indeed prescribing of cardiovascular drugs is expected to rise significantly under the new target-based GMS contract. Despite this, Pfizer does not have a strong presence in treating the condition itself although this will change when inhaled insulin product Exubera is launched with co-marketer Aventis in late 2004 or early 2005.