Behaviour change is hard, but targeted health interventions can have a positive impact.
That’s the message that David Willows, vice-president, strategic market solutions, with Green Shield Canada, delivered at the Canadian Pension & Benefits Institute’s annual Benefit Outlook earlier this week.
Generally, Canadians have an “unrealistic optimism” about their health, Willows noted. He cited a recent study by the Canadian Institute for Health Information, in which nine of out 10 Canadians rated their health as good to excellent. Yet the incidence of diabetes has doubled in Canada since 2000, Willows said, and about one-quarter of Canadians are obese. “My message to Canada is, We need to talk.”
As the Canadian population ages and lives longer, there will be an increased burden on the healthcare system. According to Green Shield data, the 35- to 65-year-old age group accounts for 70% of drug spend. “We’re now controlling our mortality,” Willows explained. “So that brings with it some interesting questions and challenges.”
Increased drug usage—and the associated cost—is certainly an ongoing challenge for drug plan sponsors. Willows used Green Shield data to identify some of the key drivers of both drug claims and drug costs within different age bands.
Drivers of drug claims vary with age—ranging from mental health, to biologics, to high blood pressure and cholesterol. However, high-cost claimants are driving the majority of the drug spend. Green Shield data show that 20% of claimants account for 75% of drug costs.
How can we keep drug costs in check? “Health literacy” will be key going forward, Willows explained. He defines this as access to health information, the ability to communicate needs to healthcare professionals and the ability to follow instructions given by those professionals—meaning that, today, 60% of Canadians are “health-illiterate.”
There’s also evidence that appropriate interventions at the right time do make a difference. Case in point: in conjunction with the Ontario Pharmacists Association, Green Shield Canada recently conducted a study among patients with hypertension—the No. 1 reason for physician visits.
The control group of the study received standard care: the usual interaction with healthcare professionals and medication. The intervention group, in addition, received a medication review with a pharmacist, education on lifestyle factors (e.g., exercise, nutrition) and medication adherence, and regular blood pressure monitoring.
While both groups showed improvement, controlled blood pressure (i.e., patients finishing the study with their blood pressure under control) was 82% for the intervention group, versus just 26% for the control group.
In some ways, improving your health is simple: remember what your mother told you. Exercise, don’t smoke, drink less, and eat fruits and vegetables, Willows added. “You can extend your life and reduce the risk of catastrophic health events by making those changes.”
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