Provisions of the health care reform law may lead to greater acceptance of dietary supplements in promoting wellness and prevention and reducing health care costs.

Wellness and prevention sections of the law President Obama signed March 23 contain language that could impact the supplement industry.

The law funds and establishes a pilot for 10 state community health center demonstration projects designed to create individualized wellness plans for at-risk people. The plans would include dietary supplements with FDA-approved health claims, such as calcium and folic acid.

The centers are designed to test how wellness plans reduce risk factors for preventable diseases over time.

Lowering preventable disease risk factors could lead to lower health care costs in the long term.

While details of the projects are not worked out fully, the bill authorizes appropriation of "such sums as may be necessary."

The wellness plans also provide nutritional counseling and alcohol and smoking-cessation counseling and services. Risk factors include weight, tobacco and alcohol use, exercise rates, nutritional status and blood pressure.

The Council for Responsible Nutrition's senior director of government relations, Mike Greene, said the wellness provisions "go a long way to look at a whole host of modalities that deal with prevention and wellness, particularly dietary supplements with health claims."

"The information that comes out of these demonstration projects will be helpful in looking at the long-term usage and the prevention and wellness [related to] these key products," Greene said.

Daniel Fabricant, VP of scientific and regulatory affairs with the Natural Products Association, said it is "very positive" that underserved populations can receive preventive aspects through the projects.

He said the projects "could yield good data down the road" on the role supplements play in health care.

Wellness, Prevention Theme

Mark Hyman, a practitioner of functional medicine and a speaker at an NPA and CRN joint event March 24 on Capitol Hill, stressed the importance of dietary supplements in the health care paradigm.

Functional medicine is personalized health care that includes conventional and alternative therapies and helps to address underlying causes of illness and preventing complications from chronic diseases, Hyman said.

He maintained that treatment of consumers' systems instead of their symptoms could aid in wellness and prevention, and subsequently lower health care costs.

Greene said the legislation's wellness and prevention focus "really underscores CRN's belief" in terms of the roles of nutrition, eating well and smoking cessation. "It's nice that those messages are echoed throughout the prevention and wellness title of the bill," he said.

Sen. Tom Harkin, chair of the Senate Health, Education, Labor and Pensions Committee, had a hand in the wellness and prevention areas of the bill (¹ Also see "Legislation Seeks Space For Supplements On Health Care Reform Slate" - Pink Sheet, 27 July, 2009.). A champion of the supplement industry, he applauded the bill's passage in a March 23 release.

"I am most encouraged that with this reform, we will begin to re-create America as a genuine wellness society - a society focused on healthful lifestyles and preventing the chronic diseases that take such a toll on our bodies and our budgets," the Iowa Democrat said.

"And make no mistake, this bill doesn't just tinker around the edges; it changes the paradigm," he added, pointing out that the bill includes $15 billion in mandatory spending for wellness and prevention activities.

Greene said of the bill's passage, "It's good that this is behind us and we're very thankful that Tom Harkin's leadership paid off."

Greater Acceptance Of CAM

Other provisions offer new opportunities for complementary and alternative medicine practitioners to be included in health coverage. One provision sets up a National Healthcare Workforce Commission to work with the Department of Health and Human Services to establish community health teams that would include CAM practitioners, such as homeopathic physicians.

"The new health law is a starting point for a broader inclusion of CAM within the U.S. health care system," American Herbal Products Association President Michael McGuffin said in a March 24 release.

McGuffin noted language in the bill prohibits insurer discrimination against any health care provider acting within his or her license scope, which could allow for the coverage of more CAM practitioners.

McGuffin drew a line from CAM provider inclusion to the possibility of more supplement products being recommended (² Also see "AHPA Notes Opportunities For Supplements, CAM In Senate Health Care Bill" - Pink Sheet, 18 January, 2010.).

"If managed properly, greater inclusion of alternative practitioners in health care should open a pathway for increased acceptance of the dietary supplement products they provide," he said. "To the degree that they advise people to take supplements or provide supplements is a residual benefit."

McGuffin added, "The indirect outcome creates scenarios in which over the long term there will be a better incorporated use of the health-promoting products that our members offer in standard health care."

- Katie Stevenson ( ³ k.stevenson@elsevier.com )

Health Care Reform Makes Room For Supplements In Wellness, Prevention

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