Enabling Healthy Decisions

Have you ever heard of the “lipstick index”? It was coined by Leonard Lauder from Estee Lauder about a decade ago. It points to a phenomenon that lipstick sales go up when the economy declines. It happened in 2001 and right now lipstick sales are up 14% in 2011. Perhaps, more disturbingly, nail polish is up 54% this year. (Of course, further proof showed this not to be a true indicator but interesting anyways.)

But, why would it matter?

Apparently, makeup is a cheap thrill for penny-pincher shoppers. People cut back on many things, but they still need some luxury in their life. (at least that’s what the article in Time on 10/10/11 says)

I find this whole line of research really interesting given the Health and Wealth overlap. Another point in the same article was looking at whether money buys us happiness. Apparently, according to the article, happiness peaks at $75,000. I think one of the points made which many people realized post 9/11 is about the difference in happiness based on materialism versus experiences.

Interestingly, that plays into a broader discussion topic in healthcare around connectivity. Apparently, spending on travel and experiences with friends and family help enhance feelings of social connectedness (leading to a 25% increase in recreation spending from 2007-2011). Interestingly, as we’ve become more thrifty, what we define as splurges have changed. Connectivity (i.e., cell phones and Internet) have not been impacted by the recession at all.

“Connectivity has joined food, shelter and sex as a necessity.” (Paco Underhill, consumer behavior expert, Time, 10/10/11)

Infographic from http://www.randompics.net/?p=6899.

Do you remember NEHI? They are the ones that prepared the often quoted report quantifying the cost of adherence at $290B per year.

Well, they’re at it again. They’re hosting an event in Washington DC on September 22^nd to talk about adherence. And, from the participant list, it looks like everyone is signing up to be there. So, I called Tom Hubbard (Senior Program Director) and asked him some questions about the organization and the event. Here’s his responses:

• Who is NEHI?
  
  • NEHI is a non-profit research organization, headquartered in Cambridge (Massachusetts). We were created to be a “think and do tank” that focuses primarily on questions of innovation in health care. Our particular modus operandi is to be very multi-stakeholder in how we approach things: our founders deliberately set out to create a think tank, supported by member organizations that spanned multiple sectors of the health care world, including patient groups, payers, providers, academic medicine and technology firms in pharma, biotech and medical devices.  
• Why are you focused on adherence?
  
  • We started to focus on adherence because of very strong input from member organizations that adherence is one issue in health care that could prove to be one of those rare win-win propositions. At least in theory, better adherence will result in better health for patients, more effective health care that creates higher value and less waste, a bend in the cost curve, while increasing the appropriate use of drug therapies. Back when we started this work, almost three years ago, many of our member organizations felt that poor adherence was a neglected issue in health policy that cried out for greater attention and creativity from all stakeholders. (See their recent 2-page overview document.)
• Describe the current project – history, objectives, participants?
  
  • Our current project in medication adherence is an attempt to create a “roadmap” for improved adherence. We’re not ambitious enough to suggest that we can produce the kind of roadmap that some industries are familiar with —- a roadmap that lays out specific benchmarks of progress at specific points in time. Health care doesn’t work that way, for better or worse.  The medication adherence roadmap we’re devising is one that will identify what we think are outstanding opportunities for making progress on medication management and patient adherence based on the multitude of trends and initiatives that are aligning to support these goals, or could align given time and attention from decision makers. So – for example – one major opportunity that a lot of people are seeing is in initiatives around the reduction of unwarranted hospital readmissions. Cutting readmissions will involve good medication management and faithful adherence among patients, and readmissions policy represents a significant driver of new medication management and adherence strategy.
• What is the upcoming event about?
  
  • On September 22, we will hold a conference in Washington at the National Press Club to release our roadmap document and stage a discussion that will focus on how to make the roadmap a reality. We’re assembling a panel and an audience of thought leaders from a number of key sectors to explore where we can find common cause on these various opportunities to improve medication management and patient adherence throughout the health care system over the next few years.
  • Some of the panelists for the upcoming event are:
    • Joshua Benner, PharmD, Brookings Institution
    • Laura Cranston, Pharmacy Quality Alliance
    • Doug Hoey, National Community Pharmacists Association
    • Ken Majkowski, PharmD, Surescripts
    • Terry McInnis, MD, Blue Thorn Inc.
    • Michael Sherman, MD, Harvard Pilgrim Health Care
    • William Shrank, MD, Center for Medicare and Medicaid Innovation
    • Brian Sweet, AstraZeneca
    • Troy Trygstad, PharmD, PhD, Community CareNorth Carolina
    • Ira Wilson, MD, Brown University
• What is the objective of the event and how does this build on the prior report?
  
  • Our primary objective with the roadmap and the September 22 event is to help build more understanding and support for action that will promote good medication management and adherence. There’s widespread recognition that more research is needed on effective adherence promotion, so there’s a lot left to learn about how to do this well. But the health care system cannot afford the luxury of waiting. The double whammy of increasing chronic disease cases and increasing health care spending is already compelling at least some organizations to reorganize and refocus on the effective use of medications. We want to shed more light on this and build more support.
• What’s next for NEHI in this area?
  
  •  I mentioned that NEHI’s founders sought to build a “think and do tank,” so we’re interested in the “doing” part of adherence promotion. In the short ter,m this will mean working hard to disseminate the patient medication adherence roadmap among decision makers in both the public and private sectors. Longer term, we want to work with like-minded organizations to try and advance an adherence agenda that makes sense for patients and other stakeholders. Just exactly what this means in terms of our work after September 22 is something we’ll assess as we launch the roadmap.      

Or what about the Foursquare concept of location based check-in?  Would this drive traffic?  Could you cross-sell using Foursquare – OTCs, non-Rx purchases, DME?  Maybe we could ask Walgreens…

Here’s a description from Foursquare on their merchant page:

“Whether you’re a national chain, a mom-and-pop shop, or anywhere in between, you can attract new customers or reward your most loyal ones by offering foursquare Specials – mobile coupons, prizes or discounts – which are presented to users when they check in at or near your venue.  Specials create extra enticement to get customers to stop by – think 20% off a meal, a free dessert, or even a reserved parking spot for your most loyal customers.  Specials can be tailored to fit your needs, whether it’s a unique discount for first-time customers or rewards for the 10th visit (see our full menu of available Specials below).”