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  • Writer's pictureDr. S. Rallis DC, ND

One solution to escalating health benefit costs?

Updated: Nov 24, 2019

Making sure you use them!

Over 79% of working Canadians enjoy extended health benefits (1) that cover items such as prescription medications, eye glasses, services provided by chiropractors, naturopathic doctors, physiotherapists, massage therapists and much, much more! Unfortunately, most of these benefits go unused. (2)

Paradoxically, the cost of health benefits continue to rise each year. In 2020, health benefit costs are projected to increase by 6%. (3) So what’s the big deal you might ask?

For many companies, especially small and medium-sized businesses, these increases make it increasingly difficult to provide benefits to their employees. Many companies try to reduce these costs by limiting benefits, increasing deductibles, creative plan designs and the like.

But how is it, that benefit costs continue to escalate even though utilization rates remain relatively low?

The short answer is drug spending -used to treat chronic diseases of lifestyle such as heart disease, diabetes and chronic pain. (4)

So, what can you do?

Well, if you’re one of the 25 million Canadians lucky enough to have extended health benefits -use them!

Not convinced? Let me explain.

Let’s use #type2diabetes as an example. Extrapolating clinical findings from our diabetic research study (5) into potential pharmaceutical cost savings is one model that will help explain this rationale.

Patient 1 in the study was a 65 year-old female that was taking three total combined medications for her diabetes. Janumet, which is a combination of two diabetic drugs, metformin and sitagliptin and gliclazide (Diamicron is the trade name). After completing her 12-week naturopathic program of care (consisting of 5 visits), she had reduced her Janumet prescription by 75%, had completely discontinued the gliclazide and had also reduced her blood pressure medication ramipril, by 50%.

HbA1c at start of program = 7.8% (the target for most diabetics taking medication is 7.0%). (6)

HbA1c at end of program = 5.4% (normal HbA1c is less than 5.6%)

Prescription drug cost savings for this patient per year =$1,083.80

5 year prescription drug cost savings =$5,419.00

Total naturopathic costs =$425.00

Projected naturopathic costs over 5 years =$950.00

Total projected net savings over 5 years =$4,469.00

Patient 2 in the study was a 52 year-old male who was also taking Janumet (metformin/sitagliptin) to help control his diabetic condition. After a similar 12-week naturopathic program of care (consisting of 5 visits), the patient was able to eliminate the use of his diabetic medication completely. He also was able to discontinue a medication that had been used to control acid reflux (rabeprazole) as a result of the lifestyle modifications.

HbA1c at start of naturopathic program = 8.0%

HbA1c at end of naturopathic program = 5.5%

Prescription drug cost savings for this patient per year =$1,797.84

5 year prescription drug cost savings =$8,989.20

Total naturopathic costs =$425.00

Projected naturopathic costs over 5 years =$950.00

Total projected net savings over 5 years =$8,039.20

These cost savings are magnified in cases where more expensive diabetic medications, such as Victoza (liraglutide) are included in the patient’s care program. For example, eliminating a patient’s need for medication such as Victoza would result in almost 20,000.00 dollars in savings over a 5-year period of time. Most extended health benefits allot a maximum of $500.00 per calendar year for naturopathic care. Using this rationale, naturopathic care if targeted can result in considerable returns (upwards of 10:1).

This excludes any additional savings in comorbidity costs, which is often the case i.e., decreasing blood pressure meds in Patient 1 of our case study, and heartburn medication in Patient 2. With improved glycemic control, there would also be an anticipated decrease in more catastrophic comorbidities such as heart disease, kidney and liver disease, blindness and amputations. (7)

It is my strongest assertion that the most direct path to health benefit cost containment is to increase utilization of benefits that promote health and wellness. Many experts agree. ““The key takeaway from our survey is that plan sponsors are keenly aware of the need to manage rising benefits costs, but they also put a high priority on ensuring their employees are engaged and healthy,” said Greg Durant, Canadian health and benefits chief actuary at Aon, in a press release.”(8)

In summary, make preventive medicine your medicine. The best way to both treat and prevent disease is to focus on maximizing your personal wellness. Health benefits are one tool that can help afford you this opportunity!

(5) Rallis S. Optimizing glycemic control in type 2 diabetic patients through the use of a low-carbohydrate,

high-fat ketogenic diet: a review of two patients in primary care. Diabetes Metab Syndr Obes. 2019 Mar


(7) Public Health Agency of Canada (2015, December 17). Type 2 diabetes. Available from: diseases/type-2-diabetes.html. Retrieved March 17, 2018.

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