The numbers behind chronic disease in the workplace

By now, the economic burden of chronic disease in Canada has most likely surpassed $200 billion, according to Sarah Lussier Hoskyn, senior analyst, regulatory affairs and market access at Innovative Medicines Canada.

“When you think about the total health-care budget in this country, we spent $250 billion in 2017 alone,” Lussier Hoskyn said during a session at Benefits Canada’s 2019 Chronic Disease at Work conference in Toronto on June 5.

Chronic disease is a fast-growing burden for the workplace, she noted, and its impact is greater than we think. Recent numbers published by the Public Health Agency of Canada showed almost half of the Canadian population has been diagnosed with one of the top 10 chronic conditions.

Read: What are the top chronic diseases in the workplace?

The key four chronic disease risk factors are physical activity, smoking, excess weight and alcohol use, said Lussier Hoskyn. “Treating diseases caused by these factors produced $20.7 billion in direct costs, 10 per cent of the total health-care budget.”

And 80 per cent of the top four chronic diseases — with the exception of cancer — are preventable by eliminating poor nutrition, lack of physical activity, smoking and harmful use of alcohol,. “When you break it down to what the health-care system is actually spending on these conditions and then the impact on productivity loss, it’s one-third direct health-care costs and two-thirds productivity and indirect costs to society,” she said.

Read: Data key in helping employees with chronic disease, survey finds 

According to the 2018 Sanofi Canada health-care survey, 58 per cent of plan members reported being tired or fatigued; 41 per cent had difficulty concentrating; 29 per cent needed time off for health-care appointments; 30 per cent left work due to illness; 25 per cent took more frequent or longer breaks due to symptoms; and 21 per cent needed to take time to routinely monitor and care for their condition.

“The top two symptoms — being tired or fatigued and difficulty concentrating — are signs of presenteeism,” said Lussier Hoskyn. “Presenteeism is invisible, but it takes a toll on your workplace, your productivity and your bottom line.”

Indeed, between 2016 and 2018, private plan drug costs increased by 3.5 per cent per year, mostly due to utilization, she noted, adding chronic disease — with the exception of cancer — is responsible for 67 per cent of costs in the private drug cost space. In 2018, the top five drug classes, which were also responsible for drug costs, were all chronic disease therapies, said Lussier Hoskyn. “When you add those all up, they represent about 50 per cent of total private payer costs.”

Read: A look at pharmacists’ role in supporting drug adherence

When it comes to chronic disease, non-adherence is also a big problem, she added, referring to a study that looked at people who were prescribed drugs for their chronic condition. When asked whether they took their medications, more than 60 per cent of participants said they weren’t adherent all the time. Lussier Hoskyn noted the cost of non-adherence equals two to 10 days lost per employee per year. “There is clearly an opportunity to generate additional savings and optimize outcomes for patients by improving adherence.”

Lifestyle management as part of a workplace wellness program can reduce risk factors and increase healthy behaviours, she said, noting the effects are sustainable over time and clinically meaningful. “There’s reason to believe that a reduction in direct medical costs would materialize if employees continued to participate in a wellness program. . . . We estimate that the programs would be cost-neutral after five program years.”

Read more articles from the 2019 Chronic Disease at Work conference.