Impact of Compliance to Oral Hypoglycemic Agents on Short-Term Disability Costs in an Employer Population

This study evaluated the relationships between compliance with oral hypoglycemic agents and health care/short-term disability costs in a large manufacturing company. The retrospective analysis used an observational cohort drawn from active employees of Ford Motor Company. The study population consisted of 4978 individuals who were continuously eligible for 3 years (between 2001?2007) and who received a prescription for an oral hypoglycemic agent during that time. Medical, pharmacy, and short-term disability claims data were obtained from the University of Michigan Health Management Research Center data warehouse. Pharmacy claims/refill data were used to calculate the proportion of days covered (PDC); an individual was classified as compliant if his/her PDC was ≥80%. Model covariates included age, sex, work type, and Charlson comorbidity scores. The impact of compliance on disability and health care costs was measured by comparing the costs of the compliant with those of the noncompliant during a 1-year follow-up. Among these employees, compliant patients had lower medical, higher pharmacy, and lower short-term disability costs than did the noncompliant. After adjusting for demographics and comorbidity, noncompliance was associated with statistically higher short-term disability costs ($1840 vs.$1161, P<0.0001), longer short-term disability duration, and an increase in short-term disability incidence (21.5% of the noncompliant had a claim compared to 16.0% of the compliant, P<0.0001). These results suggest that medication compliance may be important in curtailing the rise of health care/disability costs in the workplace. Employers concerned with the total costs associated with diabetes should not overlook the impact of compliance on short-term disability. (Population Health Management 2014;17:35-41)Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/140180/1/pop.2013.0009.pd

Effectiveness and cost-benefit of influenza vaccination of healthy working adults: A randomized controlled trial

Context Although the cost-effectiveness and cost-benefit of influenza vaccination are well established for persons aged 65 years or older, the benefits for healthy adults younger than 65 years are less clear. Objective To evaluate the effectiveness and cost-benefit of influenza vaccine in preventing influenzalike illness (ILI) and reducing societal costs of ILI among healthy working adults. Design Double-blind, randomized, placebo-controlled trial conducted during 2 influenza seasons. Setting and Participants Healthy adults aged 18 to 64 years and employed full-time by a US manufacturing company (for 1997-1998 season, n=1184; for 1998-1999 season, n=1191). Interventions For each season, participants were randomly assigned to receive either trivalent inactivated influenza vaccine (n=595 in 1997-1998 and n=587 in 1998-1999) or sterile saline injection (placebo; n=589 in 1997-1998 and n=604 in 1998-1999). Participants in 1997-1998 were rerandomized if they participated in 1998-1999. Main Outcome Measures Influenzalike illnesses and associated physician visits and work absenteeism reported in biweekly questionnaires by all participants, and serologically confirmed influenza illness among 23% of participants in each year (n=275 in 1997-1998; n=278 in 1998-1999); societal cost of ILI per vaccinated vs unvaccinated person. Results For 1997-1998 and 1998-1999, respectively, 95% (1130/1184)and 99% (1178/1191) of participants had complete follow-up, and 23% in each year had serologic testing. In 1997-1998, when the vaccine virus differed from the predominant circulating viruses, vaccine efficacy against serologically confirmed influenza illness was 50% (P=.33). In this season, vaccination did not reduce ILI, physician visits, or lost workdays; the net societal cost was $65.59 per person compared with no vaccination. In 1998-1999, the vaccine and predominant circulating viruses were well matched. Vaccine efficacy was 86$11.17 per person compared with no vaccination. Conclusion Influenza vaccination of healthy working adults younger than 65 years can reduce the rates of ILI, lost workdays, and physician visits during years when the vaccine and circulating viruses are similar, but vaccination may not provide overall economic benefits in most years.Link_to_subscribed_fulltex