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Cash to follow the doc’s orders

Tuesday, June 15th, 2010



The bad health effects of missing medication doses costs the US health system on the order of billions of dollars each year. University of Pennsylvania researchers devised a reward system to get people to stay on track with their prescriptions.

The University of Pennsylvania has an entire center devoted to so-called health incentives — ways to get people to lose weight, quit smoking, or take their pills. Kevin Volpp is the center’s director. He says there’s huge resistance among patients for doing what’s in their best health interest.

Volpp: There’s study after study which shows that if you put somebody on a medication even in the throes of a heart attack, you put them on a statin, and half the people stop taking it in one to two years.

In Volpp’s latest program, for each day patients took their blood-thinning pills, they were entered into drawings of prizes up to 100 dollars. Volpp says the lottery system reduced the rate of missed doses from 23 to three percent.

Employers and health insurers have adopted various incentive programs to get people to exercise and quit smoking; Volpp’s is a relatively novel approach to use cash for taking medication.

Jon Christianson, a professor at the University of Minnesota, says researchers are still working to develop rewards that will impact more difficult-to-change behaviors.

Christianson: What everybody wants to know is how much money does it take either in terms of a reward or a penalty to get people to make very basic changes in their life…stopping smoking, eating differently, exercising.

Health incentives have been around for years, but they are somewhat controversial. Critics say they can sometimes unfairly reward people who have had unhealthy behaviors, or penalize people who may take the correct action, but don’t show significant improvements.


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