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How Can You Win the War Against Expensive Health Care Costs?

July 10, 2023

Grandma might have had the answer all along.

You’ve probably heard the old adage “the straw stirs the drink.” For most health insurance plans, the proverbial straw is a handful of claimants who are responsible for 70-80% of all claim costs.

A significant portion of those claims are the result of specialty drugs used to treat certain auto inflammatory diseases. These drugs are advertised widely on TV these days – Humira, Stelara, Skyrizi, Otezla and Enbrel, to name a few.

These drugs are extremely expensive (some top $100,000 per year), and all are used in some fashion to treat diseases such as colitis, Chron’s, migraines, psoriasis, psoriatic arthritis and rheumatoid arthritis. To make matters worse, the cost of these drugs continues to grow as more people are diagnosed with these diseases.

To address this problem, many life sciences companies are trying to steer health care toward more sustainable options.

Some are embracing the once-fringe concept of functional medicine. The idea of a balanced life with adequate amounts of sleep, exercise and a proper diet makes sense.

Couple these basic concepts of health with a team of medical professionals trying to understand how your body metabolizes certain foods and if it has vitamin deficiencies, and you get a very unique way to attack auto inflammatory diseases. Layer in pharmacogenetic testing, gut health evaluations and blood analysis, and you get a roadmap for cutting-edge, functional medicine.

However, this only works if patients agree to change their behavior, which can be hard. Unfortunately, it’s much easier to simply take a pill and make it go away. It’s a big reason why we, as a society, find ourselves in this very position.

External coaches can help. They actively engage members to create and stick to a plan where behavioral change happens. Whether in-person, over the phone or via a video call, being accountable to a coach can help break those pesky habits and open the door to meaningful behavioral change.

So, the next time you see a drug commercial on TV or start humming its catchy jingle, remember there’s a different path emerging to reverse auto inflammatory diseases. It’s based on the common sense advice of moderation and healthy habits that you’ve been hearing all your life.

Contact us to learn how the advisors at Oswald can work with insurance carriers and the medical community to provide better, more targeted treatment for your employees.

For more information, visit our Employee Benefits page or contact me directly:

Gene Pompili
VP, Risk Leader, Group Benefits


Note: This communication is for informational purposes only, and is not intended to offer legal, tax, or client-specific risk management advice. Information in this communication is not meant to describe specific coverages that may be advisable or available to you or your company, or to interpret specific coverages that may already be in place. General insurance descriptions in this communication do not include complete insurance policy definitions, terms, and/or conditions, and should not be relied on for coverage interpretation. Actual insurance policies must always be consulted for full coverage details and analysisView our privacy notice.