Smart Prevention - Spend a Little, Save a Lot

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Note to reader: This article is based on information from a Frost & Sullivan economic analysis, "Smart Prevention-Healthcare Cost Savings Resulting from the Targeted Use of Dietary Supplements."


The report was funded through a grant from the CRN Foundation. I just survived all those back-to-school sales at the local mall: "save $50," "save 40%," "save more when you buy more..." But here's the thing, in the case of all these great bargains, you have to spend money to save money, and I can save even more money by not buying my kids those designer jeans, athlete-endorsed sneakers and official team logo jerseys at all.


If only healthcare expenses for employers were like that-if we could just decide not to spend the money. Instead, all the demographic and medical data indicates healthcare expenses will just keep escalating. After the passage of the Affordable Care Act, employers are even more on the hook, at least for the insurance premiums, of their employees.


And chronic disease rates are working against us. For example, consider coronary heart disease (CHD), the leading cause of death in the U.S. Between now and 2020, America will spend almost $78 billion a year, every year, on hospital utilization for CHD-related events.


That's an average of $13,317 a year for each person who experiences one of these medical events, much of which is ultimately borne by employers who pay the insurance premiums. Then consider that osteoporosis affects 8.2 million women over the age of 55, and more than 1.2 million of them suffered a fall or fracture related to their osteoporosis in 2012.


With an average treatment cost of over $11,000 per person, we're spending over $14 billion a year in direct healthcare costs to treat the fractures, not counting lost productivity, mobility and quality of life.Unlike those department store sales, the only way to reduce the healthcare costs later is to engage in prevention now.


Employers are looking for ways to improve the health of their workforces and reap cost savings in return. Finding ways to keep employees healthy can translate into lowering insurance premiums. It can also mean more productivity, higher morale, fewer missed days from work, and less turnover.

Keeping Employees Healthy = Saving Money

Growing awareness of the rewards from preventive healthcare has led to a cottage industry to implement smart practices that prevent chronic illnesses and lower medical expenses, which translates into lower premiums. From weight loss coaches and gym memberships to incentives for early diagnostic screenings and mental health interventions, employers are wagering that money spent now to refocus their healthcare outlay from sick acute care to keeping employees healthy in the first place will pay off.


The numbers certainly suggest employers may be on to something. According to the Centers for Disease Control and Prevention, America currently spends approximately 75 cents of every dollar spent on healthcare on treating preventable diseases.


Meanwhile only three cents per dollar of healthcare expenditures are invested in disease prevention programs. The focus of these programs is to identify those individuals with certain risk factors or early stages of a disease and motivate them to change lifestyles and behaviors to ones that are associated with lowering the risk of medical events associated with the disease.


Adopting a prevention regimen can help mitigate the damage to individuals' health along with avoiding the financial impacts that occur from these chronic, but preventable, diseases. That's where certain dietary supplements can help. The health benefits of dietary supplements-including vitamins, minerals, other important nutrients like omega-3 fatty acids and protein, probiotics, and a host of herbal ingredients like melatonin, echinacea and garlic-are as varied as the products themselves.


Recently the Council for Responsible Nutrition Foundation (CRNF) tasked the economic firm Frost & Sullivan to focus on just eight specific dietary supplements and answer the question: could regular use of these supplements at preventive intake levels by people with certain diseases or at risk of those diseases reduce overall healthcare spending? The answer Frost & Sullivan reported was a resounding yes.

Reducing Heart Disease Risks with Dietary Supplements

One such disease is CHD, which accounts for one in six deaths per year. Medical-related expenditures for adults over the age of 55 with CHD exceeds $60 billion year. Among those diagnosed with CHD, 16 percent will experience a medical event from their disease.

According to the recent Frost & Sullivan report, four different dietary supplements can each play an independent role in reducing CHD risks. Omega-3 fatty acids lower triglycerides and support healthy blood flow; B vitamins help reduce homocysteine that could promote hardening of the arteries; and phytosterols and psyllium dietary fiber both help lower cholesterol.


Elevated triglycerides, homocysteine and cholesterol are all recognized risk factors for CHD so research has demonstrated that keeping these levels in check can help prevent the onset of CHD, or help manage it so it doesn't lead to a medical event, like an emergency room visit or a hospital stay.


While taking any of these supplements is no guarantee to prevent CHD, the medical literature demonstrates that each of these dietary supplements can reduce not only the risk of the disease, but can also reduce the risk of medical events associated with CHD.


For example, regular use of phytosterols by people either already diagnosed with CHD or at high risk of the disease reduces the risk of having a CHD-related medical event by over 11 percent. Given the prevalence of CHD in this country, that reduction translates into $4.2 billion in avoided medical expenditures annually.


And that doesn't even take into account the lost time from work, lost productivity, and rehabilitative costs associated with these occurrences. Of course, not everyone who uses a phytosterol supplement receives a guarantee against experiencing a medical event associated with CHD-phytosterol use is just one of several lifestyle choices that lower CHD risk-but as these products have an average cost of only 15 cents a day.


Frost & Sullivan was able to determine the overall costs of providing supplementation to the entire at risk population over 55 years old. Even accounting for the expense of that intervention for the entire at risk population over 55, phytosterols provided a net cost savings of $3.3 billion and could avoid 283,389 medical events a year.


Spend a little now, save a lot more later. The numbers for the other dietary supplements examined by Frost & Sullivan to address CHD were similarly impressive. Omega-3s were demonstrated to reduce the risk of a CHD-related medical event by 6.9 percent, avoiding over 1 million events between 2013 and 2020.


At an average daily cost of 25 cents, omega-3 usage among 55 year olds with CHD could reduce healthcare costs by almost $350 million a year. B vitamins produced a net cost savings of $654 million a year.


Dietary fiber supplements, with an average daily cost to consumers of 30 cents a day, could reduce the risk of a CHD-related medical event by 11.5 percent and produce $2.5 billion in net cost savings a year, after the expense of the supplements was considered.

Preventing Falls & Fractures from Osteoporosis

Osteoporosis is the most prevalent bone disease in the U.S., affecting an estimated 8.2 million U.S. women over the age of 55. Between 2013 and 2020, America will spend more than $135 billion on hospital procedures and emergency room visits related to osteoporosis.


So again, Frost & Sullivan queried the cost savings from the use of supplement regimens like calcium and vitamin D or magnesium in slowing the progression of the disease and reducing the risk of falls and fractures from osteoporosis.


Research has demonstrated that the combination of calcium and vitamin D can help increase bone mass, while magnesium can increase bone mineral density, both helping to prevent bone loss, making bones stronger, and reducing falls and fractures from the disease. The Frost & Sullivan report revealed that a daily calcium and vitamin D regimen among women over 55 with osteoporosis could reduce the risk of having an osteoporosis-related medical event by 18.6 percent.


Similar to the CHD outcomes discussed earlier, money spent on supplementing now can pay dividends down the road. Widespread supplementation could mean avoiding over 151,000 fractures every year.


With medical costs associated with osteoporosis averaging nearly $17 billion a year, the risk reduction translates into a net cost savings of $1.5 billion. Similarly, use of magnesium supplements could produce $595 million in annual cost savings.

Putting Money Back into the Healthcare Bank

The examinations of lutein and zeaxanthin for age-related eye disease and chromium picolinate for diabetes-related CHD were also examined in the report with similar outcomes. Both of these supplement regimens, like the other six already discussed, produced substantial savings. By reducing the likelihood of expensive medical events (as well the reducing the risk of the diseases themselves), these dietary supplements produced a positive net effect.


The overarching and recurring message of the research is that the programs encouraging the targeted use of dietary supplements in populations at risk of suffering a medical event from certain diseases provides substantial cost savings.


The choice between not using these dietary supplements and waiting for the disease to manifest, or taking an active role in helping to prevent, or at least delay, the onset of the disease by engaging in a regular supplement regimen is clear.


Supplement use, even when considering the daily costs of supplementing large populations of at-risk individuals, is a smart choice, producing significant savings to the healthcare system, and ultimately to the parties responsible for paying for the provided care or funding the insurance premiums that underwrite the care.

Dietary Supplements Are Affordable and Accessible

The question for employee benefits managers is how to integrate these findings into their employee wellness programs for cost savings. Luckily, the dietary supplements examined by Frost & Sullivan are all widely accessible in the U.S. through a variety of self-service retail channels-no prescription required.


Along with wide availability, they are inexpensive additions to a nutrition routine, ranging from 9 cents to 30 cents a day. The greatest barrier to implementation is simply educating one's employee base to the potential benefits these supplements can provide and encouraging employees to talk to their healthcare practitioners about their own risk factors for these chronic diseases.


Supplement costs don't necessarily need to be absorbed by the employer. Given the relative affordability of these dietary supplements, many consumers are able to afford these products as part of the regular shopping routine. However, some employers have found creative ways to include a supplement incentive in their wellness offerings (along with gym memberships, or access to nutrition counseling or exercise classes).


Whether the benefit manifests as negotiated discounts on the employees' supplement purchases, an annual supplement "allowance" or reimbursement for these products, or even full coverage for retail supplement purchases, it pays dividends. The feeling of empowerment from taking charge of one's health has other positive effects, too.


Another recent study demonstrated that users of dietary supplements were also more likely to exercise regularly, visit their doctors, try to maintain a healthy weight and less likely to smoke. So it seems that regular use of dietary supplements becomes part of a constellation of healthy behaviors.


Whether supplement use triggers other healthy habits, or the desire for better health leads to the variety of behaviors that includes taking supplements, what is clear is that supplement use becomes one of many healthy actions leading to better wellness.


Employers have every reason to foster that routine and then reap the benefits of a healthier, empowered workforce. Unlike the sales at the mall, this is money well spent. And hey, if you missed the back-to-school rush, those Black Friday sales are just around the corner.

About the Author

Steve Mister President and CEO Council for Responsible Nutrition the dietary supplement industry's leading trade association. For more information on CRN, visit www.crnusa.org, or its Foundation, visit www.crnusa.org/CRNfoundation.