Three of the biggest drivers of health care costs

Americans face a complicated picture of health in 2023. A growing number suffer not only from obesity, but also from diabetes or cardiovascular disease – and often all three. This triple diagnosis, called “cardiodiabesity,” threatens the health of patients and raises the cost of care. Rising pharmacy costs strain budgets further.

For plan sponsors, cardiodiabesity imposes challenges beyond escalating health care costs. Employers must contend with decreased productivity, missed workdays, and other bottom-line burdens. All of this makes finding the right solution a priority. 

Health care trends show comorbid conditions on the rise

Cardiodiabesity is on track to become an epidemic of historic proportions as the rates of its comorbid conditions tick upward.

Between 1999 and 2020, the rate of adult obesity in the United States climbed from 30.5% to 41.9%. The prevalence of adult diabetes increased steadily over a similar period. Although the heart disease death rate had declined for nearly a decade leading up to 2020, it surged in the wake of the COVID-19 pandemic.

Obesity, diabetes, and cardiovascular disease have become part of life for a large segment of the population. These conditions limit activities of daily living and require ongoing medical attention, with patients at greater risk for poor health outcomes, including premature disability and death.

• Obesity affects 19.7% of children and 41.9% of adults. Patients with obesity are more likely to develop diabetes and cardiovascular disease.
• Diabetes affects 11.3% of the population. It puts patients at risk for a variety of conditions, including heart disease and stroke. Diabetes places among the leading causes of death in the United States.
• Cardiovascular disease, left untreated, can lead to heart disease and stroke. Heart disease tops the list of leading causes of death. It causes one in five deaths in the United States.

How chronic conditions impact budgets

Chronic conditions drive the country’s $4.1 trillion annual health care expenditure, accounting for 90% of costs. Obesity costs the health system roughly $173 billion a year, while heart disease and stroke cost the health system roughly $219 billion a year. Meanwhile, diabetes cost an estimated $327 billion in one year, including both health system expenses and lost productivity.

Hospital stays, doctor’s visits, and the cost of prescription medication contribute to the massive price tag that comes before the value of lost work.

As the incidence of cardiodiabesity continues to rise, the pressure on the health care system intensifies. For plan sponsors, the need for a solution becomes more urgent.

How plan sponsors can navigate cardiodiabesity

Addressing cardiodiabesity requires a methodical approach that taps into data and analytics. With so many options available, plan sponsors should focus on data-driven solutions designed for comorbid conditions.

They should look for features such as:

• Client-specific clinical and financial insights
• Integrated vendor partnerships that support interventions to close care gaps
• Utilization management to decrease pharmacy spend, realizing savings on formulary
• Guaranteed results that show reduction in wasteful spending and improvement of clinical outcomes

Sharing data about clinical interventions and medical claims with a pharmacy vendor will be critical to managing these conditions. Implementing a solution today can help improve health outcomes and stabilize expenses in the long term. If members can maintain their well-being, better health and healthier budgets will follow.