Two Web-First articles published today by Health Affairs analyze factors driving medical spending and the potential of certain strategies to curtail spending growth.  One study evaluates the evidence on workplace wellness programs and finds that the medical savings outweigh the costs for employers.  The second breaks new ground by developing a Cost of Diabetes Model and reporting that the national economic burden of that disease to have reached $218 billion.

Workplace Wellness Programs Can Generate Savings
By Katherine Baicker, David Cutler, and Zirui Song, all of Harvard

With investment in disease prevention and wellness viewed as promising ways to achieve better heath and lower medical costs, workplace-based wellness programs are much touted in policy discussions.  The authors conducted a critical review of more than 100 existing peer-reviewed analyses of employee wellness programs, many of which use health risk assessments and focus on obesity and smoking, the top two causes of preventable death in the United States.

The authors found that these initiatives save employers money both through reduced health costs for their employees and reduced absenteeism.  For every dollar spent on wellness programs, about $3.27 was saved in medical costs and $2.37 was saved in reduced workplace absenteeism.

The Economic Burden of Diabetes  
By Timothy Dall, Yiduo Zhang, Yaozhu J. Chen, and Wenya G. Yang, all at the Lewin Group, and William W. Quick and Jeanene Fogli, both at i3 Research

According to the American Diabetes Association, nearly 17.5 million people were diagnosed with that disease in 2007; another 6.3 million adults are living with undiagnosed diabetes.  The authors have created a Cost of Diabetes Model that combines information from peer-reviewed literature, analyses of national survey and medical claims databases, and government statistics.

For 2007, they calculated that the national economic burden of diabetes and pre-diabetes was a staggering $218 billion, which included $153 billion in medical costs and $65 billion in reduced productivity.  This translated to approximately $700 per person. The $65 billion estimated productivity loss associated with diabetes came from higher levels of absenteeism, working at less than capacity, and early mortality. 

The authors note that the Diabetes Prevention Program study shows that lifestyle changes (diet and exercise) can help delay or prevent the onset of diabetes.  They conclude, “The burden of diabetes to society is even higher when one considers intangible costs from reduced quality of life…underscore[ing] the urgency to better understand the cost-mitigation potential of prevention and treatment strategies.”