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Forbes’ Shaywitz Takes On Aetna’s DNA Collection Program

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Whoever concluded that more is learned from one bridge that falls down than 100 that stay up did not included Aetna’s data in their calculations: 2 major bridge collapses, nothing learned.

Aetna first gained notoriety in these pages — and in our book, Surviving Workplace Wellness, and on The Health Care Blog — for being the first health plan to pitch expensive name-brand drugs to its members. Not just any members, but members who weren’t sick — and that someone else was insuring, since there wouldn’t be any savings.

And not members who requested them, but members who Aetna pitched them to, members who mostly didn’t want them. And not just any drugs, but drugs that were/are so controversial that they became the subject of an essay in the Journal of the American Medical Association concluding they never should have been approved.  (As a sidebar, while all of wellness is claimed, mostly falsely, to increase productivity, one of these drugs says right on its label that it reduces productivity, specifically impacting memory, attention and language.  And yet Aetna insisted productivity would increase.  Using a drug that reduces productivity to increase productivity truly puts the “off” in “off-label” use.)

So what did they learn from a failed wellness program that was expensive, intrusive, ineffective, and incredibly unpopular using a third-party that doesn’t seem to know what it’s doing?  Their takeaway was: “Let’s come up with a program that’s even more expensive, intrusive, ineffective, and incredibly unpopular using another third-party that doesn’t seem to know what it’s doing…and, for added measure, let’s lie about the outcomes.”

And thus they hatched their scheme to bring DNA surveillance into the workplace. Not to identify possibly useful mutations, but to estimate the risk of diabetes and heart attacks.  And not: “We’ll cover this testing if you go to the doctor and together decide whether to order it.”  Rather: “You’ll forfeit money if you don’t agree to this, and our partner gets to keep your DNA and re-sell it.”

We’ve already covered the intrusiveness, and fact that their partner, Newtopia, seems unable to understand basic arithmetic and science.  We’ve also covered their reference-site-from-hell, which didn’t exactly embrace this program.

Most recently, we’ve covered the lying-about-outcomes angle. Because the program is going to sell for up to $700, Aetna had no choice but lying– they needed to “show” $1400 in savings to achieve a 2-to-1 ROI.   Scroll down to the comments — the most respected member of the editorial board of the journal that published their outcomes now says they never should have published the study. (He himself hadn’t reviewed it.)

But all of our exposes are trumped by David Shaywitz. Writing in Forbes, he points out that the entire idea of using genetics to predict and manage obesity-related illness is, to use a technical genomics term, stupid.

We’d urge reading the whole posting (though he doesn’t get into Aetna/Newtopia until page 2), but here are the takeaways:

(1) “The three variants examined by Aetna/Newtopia explain a very very small fraction of genetic risk;”

(2) “Even if you carry the harmful genes, there is no obvious course of action” different from standard diet-and-exercise.

Shaywitz — who may have done more research before writing this column than Aetna did before starting this program — also clearly distinguishes this type of genetic information from identifying (for example) the BCRA1 mutation, which might actually be useful. “Useful” is not a term found often in wellness programs so you won’t be surprised to hear that Aetna doesn’t include BCRA1 mutations in theirs.

What are the takeaways?

First, Aetna’s wellness programs need some adult supervision.  Programs like these should never be allowed out the door.  Of course, not offering wellness is not an option. It is way too profitable, and if they don’t, someone else will.  However, there are plenty of other ways to rip off employers and humiliate employees that are less expensive and less intrusive than the two Aetna has come up with.

Second, Quizzify is making a bet that — especially because Aetna is not hiring any of them — there are a lot of smart people still out there, people who would prefer to pay a low price for an employee health program that is non-intrusive, fun, guaranteed to save money, Intel-GE Validation Institute-validated, and carries a Harvard Medical School imprimatur than pay a high price for programs that don’t work and employees don’t like.

Yes, we know it’s not always about us, but we appreciate Aetna’s efforts to make us look good by comparison.

 

 

 

 


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