Connecting the dots between gas and health costs

Rite Aid, a top retail pharmacy chain, awarded its first Fill Up & Fuel Up gasoline gift cards this week.

I’ve been writing about gas ‘n health care since the inception of the Health Populi blog; see this inaugural post.Gas

Now comes a pharmacy connecting the dots between consumer spending categories: the interdependency of fuel and prescription drugs.

As the differences between price tiers of prescription drugs have increased over the past ten years, I’ve often asked pharma clients the question: what is the consumer’s marginal value of that $20 (or $30 or $50) co-payment compared to something else on their shopping list — say, a new electric razor for their husband, or that $95 jar of anti-aging skin cream?

While confronted with smirks several years ago, no more. Rite Aid gets this.

They’re giving $30 gas debit cards with the transfer of a prescription to their store. If the Rx stays with Rite Aid, consumer’s name stays in play to win the gas lottery — a $2,600 gas card.

Rite Aid is in 31 states with about 5,000 outlets. This game can’t be played in New Jersey or New York due to regulations in those states.

There’s another different sort of "Gaming for Meds" story to discuss. Aetna is sponsoring a study to see if a lottery can enhance patients’ adherence to prescribed drugs. The Aetna Foundation funded a Universtiy of Pennsylvania team to use prizes of $0 and $100 to reward consumers to take drugs as prescribed. An electronic monitor (the Med-E-Monitor) will track whether 100 participants are taking their warfarin. 50 patients will be enrolled in the lottery with a 1 in 10 chance of winning $10 a day, and 1 in 100 chance of winning $100. A text message will be sent each day to tell the patient whether he/she won the lottery, or if the dose wasn’t taken, whether they would have won the money. 50 people in the control group will be using the electronic monitor but won’t be incentivized with the lottery game.

The rationale? Medication adherence is a real problem in health care. It costs the U.S. $177 billion annually in direct and indirect costs, according to the National Council on Patient Information and Education. Results of the U-Penn trial will be out in spring 2009.

Jane’s Hot Points: The Rite Aid and Aetna stories represent two major health stakeholders confronting consumer realities, and doing something creative to meet the consumer where she lives: in the real world, paying megabucks at the pump and @retail in general. In the case of the U-Penn pilot, it will be instructive to learn the outcome next spring. Some health plans are already dropping Rx co-pays for selected chronic care medications to increase patient adherence. Those doing so have found that they can achieve real ROI as fewer enrollees show up at emergency rooms for care, and as employers see their employees appear (and be more ‘present’) at work. The roots of this are in the famed Asheville project.

Furthermore, the theme of games is growing in importance in health. Take a look at the Robert Wood Johnson’s Games for Health program. People like games, and here’s another way those organizations who serve patients can become part of their lives in more engaging and constructive ways. Dare I say — even fun?! 

7 replies »

  1. The Center for Media Research has released a study by Vertical Response that shows just where many of these ‘Main Street’ players are going with their online dollars. The big winners: e-mail and social media. With only 3.8% of small business folks NOT planning on using e-mail marketing and with social media carrying the perception of being free (which they so rudely discover it is far from free) this should make some in the banner and search crowd a little wary.

  2. As practicing physician, I see a problem in the way healthcare is incented. I believe that “the system” which is actually just a marketplace, is delivering exactly what it is incented to deliver. Health care cannot escape the market economy, in which we exist. It cannot exist in a vacuum. Solutions have to fit within our primaily capitalist ideology. We have to incent what we want. Prevention is non-existent because there are only incentives to allow people to get sick and then try to rescue them. Doctors today could not even provide prevention, because they are largely too specilaized. (Generalist are just thinking like them.) This makes them “parts experts,” unable to connect-the-dots between body parts. Unable to even recognize that they are almost all just treating the same things in different parts of the body, calling them by different names. An “add a drug for every symptom” approach to medical care incents simply continuing to come up with more drugs every symptom. There is no incentive to find the cause of any disease, provide any “cures” nor prevent any disease.
    The current diabetes epidemic highlights this issue better than any other. We in medicine saw this pending epidemic, and discussed it, ad nauseum, for at least 2 decades before its arrival. However, we were impotent to stop it. The market is more powerful. Now diabetes is just a cottage industry. You can sell diabetics drugs, testing supplies and when they get complications, you can sell them procedures and even more drugs. Where is the incentive to make that go away. Insurance companies are currently underwriting the sustanence of this behavior. Their narrow undersanding of the flawed model of care, has them rearranging the chairs on the Titanic. They are NOT going to save any money by paying for more and more for drugs that they then feel compelled to remind patients to take. All of us will be victims unless we are able to see through the smoke. We have to find wellness for ourselves. Our health care premium dollars are being given to companies who are purchasing rescue care for us, not prevention.
    M.J. Thomas, MD

  3. You are misinterpreting the promotion and incorrectly stating that Rite Aid is giving away $30 gas debit cards with a transferred prescription. The 30.00 gift card is NOT A GAS DEBIT CARD, it is a RITE AID GIFT CARD that can be used in the Rite Aid store on merchandise. Customers redeeming a “Fill Up & Fuel Up” coupon available in Rite Aid weekly circulars and other advertising and promotions materials receive a $30 RITE AID GIFT CARD immediately for transferring a prescription. They are then entered into a drawing for year’s free gas and continue to be eligible for weekly drawings for a year’s worth of free gas through Jan. 10, 2009, as long as their transferred prescriptions stay with Rite Aid. Every prescription transferred with a coupon gives the customer another chance to win.

  4. The fact that Rite Aid has to invent a game to get customers to take their proper medications is an ironic consequence of the way drug companies, HMOs, and their friends in Congress have been gambling with the public’s health, inflating costs to increase their profit margins. Having the prize be free gasoline only doubles the irony, as the oil companies have been playing the same game in Washington as the pharmaceutical industry. It’s time to send people to Washington who will put the public interest first, in healthcare and in the energy sector.
    I am a practicing physician, and if I’m elected to Congress, I will work to cut healthcare costs by promoting disease prevention and chronic disease maintenance, and providing comprehensive coverage for those struggling to pay for their medications and doctor’s visits. I also support boosting federal investment in alternative fuels and energy conservation programs, which will lead not only to a safer and less expensive energy supply, but will also create good jobs in America. It’s time to stop playing games and start getting serious about keeping our country healthy and prosperous.
    – Teresa Sue Bratton
    Candidate for US House of Representatives
    North Carolina’ 6th Congressional District

  5. Rite Aid’s or Chrysler’s gas cards are like feeding an addict’s habit – it’s counter productive to the final solution. High gas prices are not the problem, they are the solution. The problem is that the profits from high prices flow out of the country or into the oil corporations for more investment in, guess what oil dependancy, and are not redirected to supporting conservation and alternatives. You can thank the present oil administration in Washington for that. More failed policies. If we want to get rid of gasoline dependency then we need to find other methods than the enabling addiction of gas cards.

  6. It was time for Rite Aid to start doing cards like this!
    Really necessary in all citizen of the USA, Rite Aid is more than a Pharmacy, it is part of our life, daily, we can pass by it and go in, even to get the newspaper, we always have a reason, because in Rite Aid we find everything we need in our daily life!
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