Grandma might have had the answer all along.

You’ve probably heard the 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 autoinflammatory 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 unique way to attack autoinflammatory 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 autoinflammatory 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 experts at Oswald can work with insurance carriers and the medical community to provide better, more targeted treatment for your employees.