Can New Type 2 Diabetes Treatments Reduce Benefit Plan Costs?

April 12, 2017 Jerod Zakson

So you want to save money on your benefit plan. This is a challenge I have helped clients with over and over throughout my career. While there is no one size fits all solution, I think there is an undervalued silver bullet that plan sponsors are not taking advantage of. In fact, they are undercutting it and carving it away as an unnecessary expense.

“…why not start applying the protocols to attempt to achieve remission of any duration now?” Lizann Reitmeier, Conduent HR Services Health Practice Leader, Canada.

A recent study by McMaster University scientists revealed that it may be possible to reverse Type 2 diabetes in some patients, and this condition, thought to be permanent may actually be curable. In fact, 40% of the participants in the study were cured after 4 months of treatment. That’s right, cured, not treated. And while they are actually using the word “remission” rather than “cured” the results remain promising. The senior investigator of the study warns that the results of the study cannot yet confirm the long-term success of the protocol but shares my optimism. He says, “The findings from the pilot study showed us that there’s smoke. We are now looking for the fire in new studies that will give us a better idea of how many people may benefit and for how long.”

Type 2 diabetes is an insidious disease that can lead to many serious medical complications if unchecked. Current treatment protocols include drugs to reduce the blood glucose, as well as drugs for high cholesterol and high blood pressure where required. The complications of unchecked Type 2 diabetes include nerve damage, blindness, kidney failure and even gangrene. Not pretty. And Type 2 diabetes is spreading around the globe like an epidemic, likely due to our diet of processed foods in abundance and our sedentary lifestyles. It is also one of the most common conditions driving drug claims.

In an interesting twist, blood glucose test strips, which are also covered under drug plans, have become a hot commodity on the black market and a surprising target of fraud under benefit plans.

So what does all this mean? This surely means insurers, plan sponsors and Type 2 diabetes patients have a vested interest in the long-term results of this study. But why not start applying the protocols to attempt to achieve remission of any duration now? According to McMaster’s press release, the study applied “frequent coaching, a personalized exercise and meal plan, oral medications, and insulin” for a period of 8 or 16 weeks. The participants in the longer duration program had a higher success rate, where success was normal blood sugar levels three months following the end of the intervention.

As insurers have implemented patient assistance programs for certain medical conditions for high-cost drugs, wouldn’t it be natural to expand the program to include coaching for Type 2 diabetes? In theory, plan sponsors could provide a higher level of coverage for the drugs required for treatment of employees participating in the program.

Although the skeleton of this program already exists through Employee Assistance Programs and subsidized gym memberships, both have been recent victims of high-profile benefit program reductions. Is eliminating these programs the right approach? Perhaps employers could find ways to bring their programs together to the benefit of plan members dealing not just with Type 2 diabetes, but those dealing with a host of other chronic diseases such as depression, heart disease and high blood pressure. This would make sense, since studies have repeatedly shown coaching and exercise can have a significant positive impact on an individual’s health and, it follows, on the cost of health and disability plans.

I offer kudos to the team at McMaster University for stepping outside the box with a study that could change our whole healthcare landscape. We look forward to long-term results and bigger studies.

Editor’s note: If you would like to discuss the possibility of using the existing levers in your benefit plan to improve the health of your population and impact drug and disability costs, please contact Lizann Reitmeier.  

 

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