Jim’s Take

I saw these two articles on LinkedIn.  The first one really raised my blood pressure – once again the drug makers are ripping off Americans, particularly those in private plans.

https://www.businessinsider.com/cost-first-fda-approved-marijuana-medication-epidiolex-2018-8

There is an epilepsy drug now approved by FDA.  The first one based on marijuana, and the drug maker is suggesting that it be priced at – are you ready? – $32,000 per year!!

How, you may ask, did they come up with that number?  Was it years of medical research investment?

Give me a break – we’re talking about weed here.  There a literally dozens of documented medical benefits for marijuana … are the drug makers going to price them all as if they actually invented something?  Crappola!

Maybe it’s because they have to take great pains to properly refine and purify it.

Again, Give Me a Break!!  It’s weed.  Yeah, there is certainly some purifying that you have to do so as to isolate the epilepsy-related compound in weed.  But, c’mon.  That’s a (relatively) simple chemical process.

In the article, they reveal the REAL reason it costs $32,000:  SO IT WILL COST ABOUT THE SAME AS OTHER EPILEPSY TREATMENTS!!

As I said, “give me a break,” and now we can see why the cost of medical coverage and Rx rise so rapidly.

And Here’s a Partial Answer

Article #2 focuses in on what has to be done – pay attention to the handful of people who drive your costs.  The 10-20% of the people that represent 80% of your claims.

https://www.shrm.org/ResourcesAndTools/hr-topics/benefits/Pages/managing-high-cost-claimants.aspx

I call these people “super-users” and focusing on their costs isn’t, repeat isn’t, a selfish or skinflint-like thing to do.  These are the people who need access to extra medical help most of all.  They need good outcomes; you need better costs – those two things are the obverse and reverse of the medical management coin.

That’s right; proper medical management – which the article emphasizes – does both of those things.  It improves the outcome for your employee, who desperately needs it, and it improves your EBITDA retention.

Someone once said that “good medical care is cost effective because you don’t pay for the same service twice.”

And they were right.

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