Metabolic syndrome targeted as part of efforts to reduce chronic disease drug spending

Despite rising health-care costs, there’s a gap when it comes to seeing the results of all of that spending, according to a speaker at the recent Calgary Drug Trends Summit.

“Although health-care costs are increasing, we have not seen a significant improvement in the health of Canadians,” said Dr. Doug Klein, an associate professor at the University of Alberta’s department of family medicine, during a session at the Nov. 23 event.

Treating chronic disease is a major factor in health-care expenditures. Metabolic syndrome and its complications, including diabetes, heart disease, stroke and renal failure, affect nearly one in five adult Canadians, accounting for 17 per cent of health-care costs and 43 per cent of deaths.

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According to Klein, to be successful at controlling drug costs, plan sponsors need to look beyond typical drug plan management strategies.

“There are some really expensive drugs coming down the pipe. We can do that or we can do something different,” he said, pointing to targeted lifestyle interventions that have the potential to reduce both the prevalence of chronic conditions and associated drug costs. “There is a better way. We know that if we target the right people and give them the right interventions around diet and exercise, we can prevent and decrease the rates of chronic disease and, in many cases, we can take away some of the medications. The evidence is that it works.”

Klein is part of a research group examining the impact of diet and exercise on health. In a one-year feasibility project conducted at three sites across Canada, 19 per cent of patients reversed their metabolic syndrome, and 42 per cent showed an improvement in blood pressure, blood sugar, cholesterol or abdominal obesity after working with a dietitian and exercise specialist every week for three months and then monthly thereafter. Also noteworthy was the nearly three-quarters of program participants who felt very confident they could maintain the lifestyle changes they had made in the program over the long term.

Read: Metabolic syndrome targeted as part of efforts to reduce chronic disease drug spending

What do the findings mean for Canadian workplaces? “This is where we can be really innovative,” said Klein, noting that in addition to expanding the feasibility project into health-care settings in primary care networks across the country, researchers are now doing a workplace-based change program in Alberta.

“There is a lot of evidence that health promotion programs are helpful, but where the cost effectiveness really kicks in is when you target high-risk groups, which are driving all of these costs,” he noted. “If we target these groups, we’ll see benefits faster. There is so much evidence that diet and exercise can help. If we target metabolic syndrome, we can dramatically change the health of the population, change the health of employees and reduce health-care costs at the same time.”