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Measuring the Relationship Between Employees’ Health Risk Factors and Corporate Pharmaceutical Expenditures

Burton, Wayne N. MD; Chen, Chin-Yu PhD; Conti, Daniel J. PhD; Schultz, Alyssa B. MS; Edington, Dee W. PhD

Journal of Occupational and Environmental Medicine: August 2003 - Volume 45 - Issue 8 - p 793-802
doi: 10.1097/01.jom.0000079090.95532.db

Explain whether and how corporate drug costs were related to major demographic features of bank employees in this study.Identify those lifestyle-related risk factors—ascertained using a health risk appraisal instrument—that significantly influenced pharmaceutical costs.State which of the biological risk factors examined were—and which were not—associated with increased drug expenditures.Specify how employees’ perceptions of their own health and quality of life may influence corporate drug costs. This study demonstrates the relationship between self-reported health risk factors on a health risk appraisal and pharmaceutical expenditures for a large employer. A total of 3554 employees who were participants in a pharmacy benefit plan for the entire year of 2000 completed a health risk appraisal. As the number of self-reported health risk factors increased from zero to six or more, corporate pharmaceutical costs increased in a stepwise manner: $345, $443, $526, $567, $750, $754, and $1121, respectively. After controlling for age, gender, and the number of self-reported diseases, each additional risk factor was associated with an average annual increase in pharmacy claims costs of $76 per employee. Specific health risks were associated with significantly higher expenditures. The results provide estimates of incremental expenditures associated with common, potentially modifiable risk factors. Pharmaceutical expenditures should be considered by corporations in their estimates of total health-related costs and in prioritizing disease management initiatives based on health risk appraisal data.

From Bank One, Chicago, Illinois (Dr Burton, Dr Conti) and University of Michigan Health Management Research Center, Ann Arbor, Michigan (Dr Chen, Ms Schultz, Dr Edington).

Address correspondence to: Wayne N. Burton, MD, Senior Vice President/Corporate Medical Director, Bank One, 1 Bank One Plaza, Mail Code IL1–0006, Chicago, Illinois 60670-0006; e-mail address:

W.N. Burton has no commercial interest related to this article.

©2003The American College of Occupational and Environmental Medicine