Committee pushes diabetes prevention as pharmacy bills and specialty drugs drive costs

Committee members told the Feb. 9 meeting that diabetes, cancer and heart disease are the plan’s top cost drivers, and presenters urged stronger promotion of employer wellness programs to reduce long‑term claims.

Sean Fleming said diabetes was the plan’s highest‑cost condition and gave a plan‑level breakdown: about $1.2 million in diabetes spending in 2021, of which roughly $1.1 million was pharmaceutical and $133,000 medical; he said about 211 individuals were coded in the diabetic category. "So your highest cost condition on the plan is diabetes," Fleming said.

Staff and members described existing programs to address chronic conditions: the Alana program (a prevention‑focused offering for prediabetics), FoodSmart (nutrition and dietitian support tied to Cigna) and the Motivate Me incentive that pays about $200 per year for participation. Committee members said participation is growing but remains limited; staff cited a roughly 40% email open rate and said some populations remain under‑engaged.

Members discussed outreach options — targeted union distribution, posters in facilities and selective text messaging — and debated opt‑in versus opt‑out approaches for texts; staff signaled a preference for opt‑in to avoid negative associations. Fleming and others noted that newer specialty drugs (examples cited in discussion: Humira and newly marketed high‑cost diabetes medicines) increase pharmacy spend and that carriers use step‑therapy or prior‑authorization to limit inappropriate early use.

Next steps: committee members asked staff to increase promotion of Alana and other validated prevention programs, continue to report participation metrics and track pharmacy trend lines as procurement and cost projections proceed.