Employers are making greater efforts to promote patient adherence and foster a culture of health in the workplace to help manage chronic conditions.

Three years ago at Pitney Bowes’ head office in Stamford, Conn., David Hom, then vice-president of strategic initiatives for the company, received a call from the chair, who wanted to discuss how to create a healthy workplace environment. Specifically, he wanted to use financial incentives to get employees to go to preventative screenings, with the goal of improving the health of the employee population.

While the idea of offering financial incentives might make most CEOs reach for their blood pressure pills, at Pitney Bowes, they work. “Pay ’em off,” said Hom, now chair of the Center for Health Value Innovation, an institute financed by Pitney Bowes. As a strategy to motivate employees to stay healthy, Hom remarked that “bribing is good.” Along with these “bribes,” in 2002, Pitney Bowes reduced the costs of all drugs covered under the benefits plan (both generic and brand name) for diabetes, asthma and hypertension to 10% co-insurance. “We were agnostic to the drug,” said Hom. “What we were wedded to was [prescription drug] compliance.”

The move to 10% co-insurance produced results in Pitney Bowes’ employee population. Compliance rates for asthma medication adherence doubled, particularly in the area of controller medications. There was also an increased level of compliance for diabetes and hypertension drugs, notably, for those over age 55. “Our older [employees] began taking their medications,” said Hom. “We saw less hospitalization [and] fewer ER visits.” In fact, Pitney Bowes reduced its disability days by 50% for its diabetic population.

In 2007, the company moved all of the osteoporosis drugs and prenatal vitamins covered by the benefits plan to 10% co-insurance. “Prenatal vitamins are very expensive, so [women] don’t want to take them,” said Hom. In addition, Pitney Bowes moved all of its non-smoking drugs to 10% co-insurance. “There are new drug therapies that have significant value,” said Hom. “Their results have been phenomenal, so we’re going to provide people [with] access to medications—provided that they’re getting counselling services. You can’t just give them drugs; you’ve got to get them some sort of assistance.”

Pitney Bowes hasn’t been alone in its desire to promote healthier employee behaviours. In 2006, General Motors (GM) and the Canadian Auto Workers (CAW) launched a smoking cessation challenge in partnership with the Durham Region Health Department and Green Shield Canada. The initiative was in response to a survey earlier that spring, which indicated that 18.4% of GM’s employees smoked, and 50.5% of those smokers were considering quitting within the next six months or were committed to quitting within 30 days.

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The 24-week program was available to all GM employees, retirees and their eligible family members. Program participants received an information package on self-help resources such as websites and 24/7 phone lines, as well as a list of pharmacists trained in clinical tobacco intervention (CTI), who would support participants during their nicotine withdrawal. “The services provided by CTI-trained pharmacists played a crucial role in the success of this program in assisting employees in quitting smoking and remaining smoke-free,” said Jim Beaudry, national health and wellness coordinator, CAW. “The pharmacists prepared employees to know what to expect in their quit attempts.” One employee, Beaudry said, contacted him in the first few days of the program explaining that he had headaches. If it hadn’t been for the pharmacist, who explained that this was normal, the employee may not have been successful in his attempt to stop smoking.