"If you are going to have a successful corporate program, it has to be directed from the top," says William Weldon, the CEO of Johnson & Johnson. He could be talking about cost-cutting initiatives or a new talent-management protocol. Instead, he's talking about cancer prevention.
Weldon is chairman of the CEO Roundtable on Cancer, an association of bigfoot leaders, mostly from Big Pharma, who have joined forces to create best practices for anticancer policies. Launched by former GlaxoSmithKline CEO Robert Ingram--at the urging of former President George H.W. Bush, who lost a child to cancer--the organization last year created a "CEO Gold Standard" plan.
Among other things, it requires companies that sign on to cover the full cost of cancer-related treatments that traditional insurance plans often balk at, from cancer screening to nutritional counseling to experimental treatments. They also ban smoking, not just inside their corporate buildings but outside on the grounds as well. So far, 13 companies have gone for the gold, including J&J, software developer SAS Institute, and drugmaker Novartis.
The CEOs on board say it's not about the money. "I don't think anyone is entering into this for financial gain," says Weldon. "They're entering into it for the health of their employees... To me, if we can save one life, that is profound."
Employees who have benefited from their company's anticancer initiatives are living proof of Weldon's words. "SAS took away the burden of all the other stuff, and we could just concentrate on beating the cancer," says Keith Holdaway, a software developer who has been cancer-free for five years since SAS paid for his participation in a clinical trial for a malignant tumor on his back.
It doesn't hurt that the Gold Standard does, indeed, seem to cut health costs: The roundtable hired an actuarial firm that estimated a savings of $2.35 to $3.75 per employee per month for companies that follow the plan.
This effort stands apart from traditional employee-wellness programs in more than just its rigor and single-illness focus. It also aspires to be "evidence based," meaning all of its policies should be backed by solid scientific research that proves their effectiveness.
Under the Gold Standard, companies don't have to pay for lung-cancer screening, for instance, because the tests often misidentify suspicious spots that turn out to be benign. However, screenings for colon and cervical cancer, which have much stronger clinical support, are required.
The CEO Roundtable on Cancer has also teamed up with researchers at the University of North Carolina at Chapel Hill to study the Gold Standard's effectiveness. There's "honest disagreement" over which screening tests work, says David Potenziani, director of instructional and information systems at UNC's School of Public Health.
In addition, there's not enough good research to draw any conclusions about the long-term impact and cost of corporate wellness programs that offer perks such as on-site gyms, or tests to detect osteoporosis. In the meantime, Potenziani contends, companies that sign on for such programs are doing so "as a bet. They don't necessarily have the research to support it."
Weldon thinks there's plenty of evidence to support his anticancer cause--including a five-year study of J&J's own efforts. "We can show a reduction in absenteeism, we can show a reduction in our health-care costs," he says, pointing to a study that found $225 in savings per employee in annual health costs. "We have documentation of this, as do others."
The biggest challenge to the anticancer effort, though, may be the increasingly global nature of business--and the difficulty of applying US health standards abroad. The Gold Standard accreditation only covers US sites, but some companies are enforcing it worldwide. More than half of J&J's 122,000 workers are outside the United States and it's trying to ban smoking everywhere, according to Dr Fik Isaac, its director of global health services.
But in places such as Germany and Sweden, union contracts limit the company's ability to enforce such a policy unilaterally, Isaac says. Cultural issues create other obstacles. According to the World Health Organization, even the strong clinical evidence against smoking hasn't blunted the habit in many foreign locales.
The roundtable, though, is undaunted in its mission. Its roots are in a group called the National Dialogue on Cancer, which was heavy on nonprofits and light on business leaders. It evolved into the roundtable--and has more impact--because "America's corporations are headed by CEOs who don't do dialogue well," says Martin Murphy, a journal editor and longtime researcher who works with the roundtable. "They are action-oriented."
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