'Lifestyle drugs' need insurance industry's support

With the advent of consumer-directed accounts, employers, insurance carriers and benefits brokers alike have been sending the message to employees that they need to make better lifestyle choices in order to reduce health care demand. This trend brings to the forefront a very curious idea: If health insurance carriers want consumers to live better lifestyles, could they be doing more to promote such lifestyles? In short, the answer is yes.

Roughly 18 months ago, a “lifestyle drug” – a product used to treat conditions that are not life-threatening – was approved by the Food and Drug Administration and released for sale in the United States. This drug, Chantix, is designed to help people stop smoking in two ways. First, it blocks nicotine from binding to receptors in the brain that trigger the release of dopamine. At the same time, the drug stimulates the brain to release some dopamine to reduce symptoms of withdrawal. Although Chantix is the only drug of this sort on the market, it is likely that other lifestyle drugs will be hitting the market within the next few years. These drugs have the potential to help people live a healthier lifestyle and reduce health risk factors that can lead to future health problems. In turn, this could be a benefit for employers as they try to increase overall employee productivity.

Again, the recent message of health insurance carriers is that reducing the risk factors that people have will reduce the demand for health care, and from an economic perspective, reduce the overall cost to insure people. This may be the answer to a small part of America’s health care crisis, but the focus here is to encourage health insurance carriers to support lifestyle drugs. It should be easy for insurance carriers to make the correlation between a consistent message and the support of these drugs.

While it is understandable that health insurance companies don’t want to pay the cost of lifestyle drugs by increasing premiums for everyone, what they could do is use their purchasing power with the pharmaceutical companies in order to reduce the cost of the drugs.

Right now, most health insurance companies provide no discount or any incentive for people who are actively taking lifestyle drugs. This means that the companies are not recognizing those people who are taking some steps to reduce their health risk factors. Quite simply, the insurance carrier could offer a discount to those people who are interested in taking these drugs and create an incentive for them to engage in healthier lifestyles. The insurance companies could work directly with their pharmacy benefit managers to negotiate discounts with the drug companies that have released lifestyle drugs.

This step could be beneficial for all parties. Discounts could increase volume for the pharmaceutical company; insurance companies could ensure clarity of its message and help reduce costs; and consumers could take advantage of an incentive to live healthier lifestyles.

It is time for insurance carriers to move forward on behalf of the consumer.

Southwest Missouri businesses can take action by contacting their insurance carriers or local benefits brokers and voice their support of this idea, urging carriers and brokers to do the same – and to spread the word to others in the insurance industry.

Letters and phone calls also will go a long way to help get this message to the appropriate stakeholders.

Daniel G. Ruggeri is a partner with Springfield-based Employee Benefit Design LLC. He may be reached at druggeri@ebdllc.com.