Radical prescriptions

This Wall Street Journal ($) article reports on innovative techniques that several corporate health care finance departments are undertaking in an attempt to mitigate the adverse effects that the third party payor system has on the consumer’s decision regarding health care choices. The entire article is well worth reading, and here is one of the strategies noted:

In the fall of 2001, Pitney Bowes Inc.’s corporate medical director, John Mahoney, proposed an unusual experiment: Slash the amount that employees pay for diabetes and asthma drugs, and see what happens.
On its face, the proposal seemed it would only add to the company’s escalating health-care costs. But there was a simple logic to Dr. Mahoney’s theory: If diabetic or asthmatic employees found drugs more affordable, they might take them more regularly. Over time, taking better care of their chronic conditions might reduce expensive complications.
But Dr. Mahoney says even he didn’t expect the dramatic savings that resulted. Since 2001, the median medical cost for a Pitney Bowes employee with diabetes has fallen 12% from about $1,000 a year. The median cost for a patient with asthma has dropped 15% from $900 annually. Overall, the company says it will save at least $1 million in 2004, with continued savings in future years.
Pitney Bowes’s move is indeed radical. Amid health-care cost increases of 11% to 15% annually, many employers are taking the more obvious approach: have employees shoulder some of the financial burden by raising premiums, deductibles and co-pays. Such moves appear to be helping to slow health-care cost increases in the short term. But Pitney Bowes’s experience shows that spending more upfront to make it easier — and cheaper — for employees to manage some chronic illnesses may actually bring about greater savings in the long run.
“There’s a reluctance among many people to take this kind of a chance because conventional wisdom says it’s going to increase your costs,” says Dr. Mahoney, a former White House physician in the Ford administration.
“But health care is kind of like a balloon. When you squeeze costs in one place, they often pop up in another.”

M.D. Anderson fat pill research

Both the Chronicle and the Wall Street Journal ($) have front page stories on the research project that Dr. Wadih Arap, a cancer biologist at the University of Texas M.D. Anderson Cancer Center in Houston’s Texas Medical Center, is leading a study that offers a potential new approach to treating obesity and is also showing promise in cancer treatment. The results are being published in the June issue of the journal Nature Medicine.
Such research is becoming increasingly important because several recent studies are revealing that many of the improvements in health that medical advances have bestowed upon middle-aged and older Americans will likely be effectively erased over the next 20 years if Americans’ weight continues to increase.
The researchers said they melted away body fat in laboratory mice by cutting off the blood supply to fat cells. The agent is a drug the researchers designed to home in on blood vessels cells linked to fat tissue and then deliver an agent that induces the cells to self-destruct. As the blood vessel cells died, the fat tissue essentially vanished.
Weight-loss drugs typically seek to suppress appetite or increase the body’s metabolism to make it burn more calories. However, the body can quickly compensate for the effects of such drugs, making it difficult to lose and keep off weight. Accordingly, the new research is important because it could decrease the amount of fat in a completely novel way.
Dr. Arap cautions that only mice have been studied so far and that what works in mice often fails in people. Even if additional research goes well, it would probably be several years before any treatment could reach the market.
No corporate sponsors were involved to date in the study. The research has been funded with grants from the National Institutes of Health and several philanthropies. M.D. Anderson has filed patents related to the approach, and its institutional policies enable Drs. Arap and other researchers in the project to benefit financially if the strategy is commercially developed.
As far as potential corporate sponsors go, I recommend highly that the researchers get in touch with a certain doughnut makere.