Running Shoes Cheaper Than Medicine

When I was running the St. Louis half-marathon this past weekend, I kept thinking about something I saw recently which was a story about a patient arguing that it was cheaper for them to buy running shoes and exercise than to pay for medication. It’s an interesting point. If a patient would be willing to exercise outside (low cost), all they need is a good pair of running shoes. You probably have to replace them every 3-4 months so at $80-$100 per pair you are talking about $240 – $400 per year. It would probably be a wash for 12 copays for a brand drug on formulary, but cheaper if you had multiple drugs.

It would be a lot cheaper for the payor to provide the running shoes in return for the commitment to workout. How would you measure it? Easy. You could use a GPS and as long as the patient walked or ran X miles per month then they got the benefit of free shoes. Not likely to happen, but I think the point is that there are many creative ways to incentivize patients to be healthy which create a clear win-win.

For example, why not provide them with free (or heavily discounted) Prilosec or Zyrtec as over-the-counter (OTC) drugs? The reaction is always that this is opening Pandora’s Box to coverage of OTC (e.g., vitamins and aspirin). It doesn’t have to be. It can be controlled by requiring the patient to get a prescription for the OTC from their physician. Once they get the Rx, they fax it in as a sort of prior authorization for the drug. If the PA is on file, they can either pick it up at the pharmacy for the $0 (or discounted) copay or get reimbursed after they purchase it.