Strategies for employers include securing lower-cost alternatives for costly drugs and investing in employee wellness.
At any given time, there are approximately 13 million people living with cancer in the U.S. More than 1.6 million new cases are diagnosed annually, and more than a half-million people die of cancer in that same time span. There is hardly a person to be found who hasn't felt the sting of this terrible disease.
It isn't just patients who stagger under the weight of rising diagnosis rates, but entire companies and organizations. Although there is an emotional component when a co-worker falls ill, the real damage is measured in dollars.
According to the National Institutes of Health, cancer costs American business $216.6 billion annually. That includes $86.6 billion in direct medical costs, and another $130 billion in lost productivity due to premature death.
Michael Caligiuri, MD, CEO of the Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, talked about the crippling cost of cancer as the Ohio State University Wexner Medical Center was preparing to open its new $705 million cancer hospital. "If we want to talk about cost, we couldn't begin to compare this to what cancer costs us as a society," he says. "(It is) the most expensive disease of the 15 leading causes of death."
The costs are unfathomable. Even a single billion dollars would allow 200 companies to hire 100 people each at an annual wage of $50,000. As cancer incidence increases, it becomes more of a struggle for a business to survive, let alone thrive.STEMMING THE TIDE
Employers are fighting the cost of cancer on several fronts, beginning in their benefits offices.
Bruce Davis, principal and leader of Findley Davies Health and Group Benefits Practice in Toledo, says employers are discovering that specialty biotech cancer drugs alone are consuming about 30 percent of their available pharmaceutical monies, which generally makes up about 20 percent of the overall health care budget. In response to this rapid draining of resources, which show no signs of abating, companies are enlisting the expertise of pharmacy benefit managers. By working directly with specialty pharmacies and manufacturers, PBMs are able to acquire the drugs sick employees need, but at a lower cost.
Specialty pharmacies also work directly with the manufacturers to attempt to cut costs further. "They're trying to acquire these drugs at the deepest discount possible, and then trying to pass that discount on to the employer sponsors of the prescription drug plans," Davis says.
In the past, oncologists would often administer cancer drugs directly and there could be a fairly significant mark up on the drugs, Davis says.
"There's a balance there I think the PBMs are trying to strike with the oncologists to make sure they're paid in a reasonable, fair way for their services but yet deliver the drug in the most cost-effective manner, too."
It may take a combination of factors to strike the right balance. "The trick is to get everyone on the same page-the patients, their oncologists and the PBMs-all working together to make sure these drugs are being delivered in the most cost-effective way," Davis says. "This is all part of the strategies employers are using to sustain competitive, affordable health plans."BUILDING A WELLNESS BARRIER
Whether in the form of a healthy lifestyle or regular medical checkups, preventive care is key. According to a report by the American Cancer Society, those who do not receive basic health care are "substantially more likely to be diagnosed with cancer at a later stage, when treatment can be more extensive and more costly." This leads to higher death rates in spite of increased treatment costs, the report shows.
OhioHealth is a leader in cancer treatment in central Ohio, and wellness and cancer prevention are pursued vigorously within its walls.
"Investing in prevention and providing incentives and opportunities to lead a healthy lifestyle at work and at home can reduce costs for employers and improve the health status of associates," says Michael Bianchi, OhioHealth system VP, oncology services. OhioHealth does this for its own workforce by making it easier to be healthy. Employees can get mammograms on company time and participate in free health screenings and tobacco cessation programs
Prevention may have a cost to the employer on the front end, but the benefits far outpace the cost of a disabled workforce.
Lisa Meddock, OhioHealth system director, benefits and wellness, says free screenings for signs of breast, colon or cervical cancer help with early detection and therefore cost reduction, but the benefits go even deeper. "Other preventive services, such as nutritional counseling and exercise counseling, help associates live a healthy lifestyle."
Some incentive programs promise a payout, but employers only have to provide a benefit to employees who have gotten on board with a healthier lifestyle. OhioHealth administers the OhioHealthy Move+Improve program, which allows not only employees but also their dependents to earn up to $500 annually by being physically active, tracking their food and participating in fun challenges.
"We also offer discounts on Weight Watchers classes, on-site biometric screenings, online health assessments and discounts at various local fitness centers," Meddock says. "We want our associates to have peace of mind when it comes to their health so that they feel good and lead healthy lives. Additionally, healthier associates mean a healthier bottom line for employers."
Bianchi agrees. "Companies will not only see positive impacts to productivity and financials, but gain positive support and loyalty in the communities in which they serve," he says.
Kristin Campbell is a freelance writer.