Pharma-led disease management programs gaining acceptance
Pharma-led disease management programs gaining acceptance
Offerings more targeted, effective as kinks are worked out
A new survey conducted by The Benfield Group, a St. Louis-based health care consulting firm, shows a growing interest in workplace disease management and wellness programs sponsored by pharmaceutical companies.
This past spring, the company surveyed 145 corporate medical directors. More than half (57%) had already used disease management and/or wellness programs sponsored by pharmaceutical companies in their workplace, and 83% said they were interested in presenting such programs in the future.
"There is such an openness to dealing directly with pharmaceutical companies on health issues they view as important," notes Chuck Reynolds, principal for The Benfield Group. "Because they have a medical background and feel they can make an objective decision, corporate medical directors believe they will not be taken in by marketing."
An independent survey of corporate medical directors and wellness professionals by Employee Health & Fitness seems to support its findings.
"The pharmaceutical companies have modularized disease-specific programs that we can dollarize,’" explains Wayne Lednar, MD, PhD, corporate medical director of Eastman Kodak Co. in Rochester, NY. "In leading companies, we’re beginning to see greater enlightenment among my colleagues; it makes a lot of sense to leverage our expertise through these programs."
"We’ve not had a negative experience," adds Ronald J. Mack, MD, MPH, FACEP, corporate medical director for Public Service Electric & Gas Co. (PSE&G) in Newark, NJ, which has just recently begun implementing those programs. "They were more balanced than I had expected; and more often than not, more suitable for the diseases we wished to address than other programs we considered." (PSE&G has, in fact, targeted a medical condition that is of particular concern to companies in the Northeast — Lyme disease. See story on p. 99.)
An evolutionary process
There has definitely been a positive evolutionary process in the development and implementation of those programs, notes Reynolds, whose company has worked with pharmaceutical firms for more than five years.
"The pharmaceutical companies have become much more strategic about the employer market; they are creating programs with a very definitive purpose," he explains.
There are also fewer pharmaceutical companies pursuing the employer market. "Four or five years ago, there was a tremendous urgency to jump into the employer market. Since then, a number of pharmaceutical companies have felt burned, unable to get to their strategic objectives," Reynolds says.
Does this mean fewer choices for corporations? "Last year, we probably saw the low point, but more companies are starting to refocus," says Reynolds. "But the days of creating a real vanilla’-type program are gone for good. Now, we’re looking at more solution-oriented programs. The pharmaceutical companies can walk into the employer’s office and deal with the employer’s issues."
Mack agrees. "The programs today are well-polished; they’ve all been field-tested, they’re tried and true," he says. "The quality of the interventions, the promotional material, the graphics, the speakers we can access — all are much better than we could do ourselves. We also see the possibility of partnering in areas like screenings, which would make them more cost-effective. It’s a win-win’ situation."
A shift in corporate focus has also led to greater interest in these programs, notes Lednar, whose company has also just begun to participate. "There is an evolving change in what is needed from corporate medical directors and from corporate benefits directors," he explains. "In the past, we have been separated — not coordinated." This new coordination, he notes, has brought corporate medical directors more directly into the process of disease management.
The decision-making step
Recognizing that disease management programs can be valuable is the easy part. How do corporate medical directors and wellness professionals decide which program is right for their employees?
"One of my main responsibilities is to try and understand what the health needs and issues of our employees, their family members, and retirees are," says Lednar. "Then I must determine how the company can respond to those needs in the most cost-effective and medically appropriate way."
The first step in that process, he says, is to develop a corporate health strategy, and then implement a plan to piece together "the best that’s out there" to meet those needs in a measurably effective way.
"We look at how we can work with suppliers to take advantage of the strengths they have to meet our needs in a way that reflects the plan we have constructed," he says. "We feel very much in the driver’s seat."
Of course, he notes, health plans also offer educational programs. So decision makers must ask themselves the following questions: How do these pharmaceutical education programs complement them? Do they offer a better response to our needs than the health plans do? How do we avoid redundancy? "What is offered is one thing," Lednar notes. "How it is offered is another."
However, he adds, customization does not need to be extensive. "For us, what’s important is that our health benefits plan is not just a mechanistic way to process the payments for medical care — it is an approach to improve the health of our beneficiaries. These disease management programs can really fit in. What’s important are the health care conditions that generate medical issues, and what outcomes they cause: Death, hospitalization, medication use, sequelae, absence from work, employees who are at work but significantly impaired. What are those medical issues, and how can we get involved as early as possible and prevent the worst outcomes?"
Focus on productivity
The most critical issue of disease management — for both employers and program providers — should be employee productivity, Reynolds asserts.
"There was a point when employers said that health and productivity really were not their job — they were the health plan’s job," he notes. "But there has been a decrease in confidence that the health plan will totally look after health and productivity. Employers now count on health plans at one end of the continuum — lower costs."
Which leaves a vacuum on the productivity end. "The claim that our product can help improve productivity’ has opened up whole new possibilities for the pharmaceutical firms," says Reynolds.
The key, he notes, is the way programs are presented and sold to corporations. "Take the issue of sleep. Insomnia from a health care cost perspective is a tough case to make, but it doesn’t take more than a second to say, Sleepy employees are costing you money in terms of productivity.’ Obesity is another one — and obesity education is not a customary benefit that health plans offer."
Reynolds does have a word of caution for pharmaceutical companies: Avoid a hard sell for your products. "If you’re out to promote general health as it pertains to a therapeutic area your drug works in, great, but be very cautious about getting too branded with your messages," he warns.
Of course, only large companies have the budget to support a corporate medical director, who can be an invaluable resource for a wellness professional. But what if there is no such individual on board; how can a wellness director make an informed decision about these programs?
"No. 1, look for programs that fit strategically with where you want to take the company in terms of health and productivity," Reynolds advises.
Most of these programs are free of charge, but the pharmaceuticals companies are naturally interested in getting the word out about their product(s).
This is not necessarily a bad thing, says Reynolds. "If they’re looking to get the word out about a medical condition, more people see their doctor; and as a result, those doctors write more prescriptions for the company’s drug — that’s great," he says. "If there are other things the pharmaceutical company is looking at — for example, having the company potentially advocate for drug coverage under the health plan — then that’s a whole other issue."
By and large, however, a wellness professional shouldn’t be too concerned about a sales pitch unless it goes directly to the employees. "If the product is simply listed at the bottom of a brochure with the name of the company and the Web site address, that’s fine," Reynolds says. "You need to be aware of what the materials are, but you should recognize there may be a brand mentioned, and be comfortable with that — or just don’t do the program."
Finally, Reynolds recommends, put your considerations on paper. "Line up all the positives a program can bring — increased awareness, the provision of additional resources, having a program for little or no cost, and what it can accomplish in terms of employee health and productivity — then put down the risks, such as employees buying a pharmaceutical product they might otherwise not have bought, balance it out on a spreadsheet, and make your decision."
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