Tuesday 20 November 2018

Prescription claims according to wellness program participation for a large employer in the United States


Ray M Merrill
Brigham Young University, USA

Worksite wellness programs that include biometric screening and health risk appraisal can identify the need for the lifestyle change and prescription medication. Hence, there may be an initial increase cost of prescription medication, but the aim is to prevent more costly health problems in the future, as well as lower absenteeism and presenteeism. The purpose of the current study was to identify the number and total cost of prescription claims and copays for a large US employer according to wellness program participation, age, and sex. A retrospective analysis was conducted of prescription medication use among 6810 workers during 2013-2016. Those completing the wellness program were more likely women (32.5% vs. 22.9%, p < 0.0001) and younger (M=45.5 vs. 48.5, p < 0.0001). Approximately 72.7% (74.4% women and 68.6% men, p < 0.0001) filed a pharmacy claim. In 2013, there was no difference in the number of claims filed or total cost between participants and nonparticipants. The mean number of prescriptions changed over the study period, initially increasing but then decreasing for wellness participants. Overall the decrease was 34.7% among wellness participants. The corresponding change for non-participants was an increase of 3.4%. Mean changes in total costs showed similar patterns. In 2016, program participants filed nearly 3 fewer claims, with total cost about $329 less, on average.
Approximately 96.5% of employees filing a pharmacy claim made a copayment. Overall, copays consist of 6.4% of total insurance and employee expenditure on pharmacy claims. In conclusion, the biometric screening and health risk appraisal components of the wellness program resulted in an initial increase in number and total cost of pharmacy medication. However, over the four-year study
period, the number of claims and the total cost of pharmacy medication significantly decreased.

This Presentation had delivered by Ray M Merrill Brigham Young University, USA in International conference on Epidemiology and Public Health Rome, Italy