Employee Wellness – Everybody Wins

1. Employee Wellness – Everybody Wins Presentation to Healthier Somerset October 29, 2013 Michael C. Sokol, MD, MS Head of Wellness, North America Sanofi US

2. Agenda • US Health Trends • Wellness Benchmarking • Sanofi’s Strategy

3. Number and Percentage of U.S Population with Diagnosed Diabetes, 1958-2010

5. Obesity: Adults • More than one-third of U.S. adults (35.7%) are obese. Obesity-related conditions include heart disease, stroke, type 2 diabetes and certain types of cancer, some of the leading causes of preventable death. The estimated annual medical cost of obesity in the U.S. was $147 billion in 2008 U.S. dollars; the medical costs for people who are obese were $1,429 higher than those of normal weight.

6. Obesity: Children • Approximately 17% (or 12.5 million) of children and adolescents aged 2—19 years are obese. • From 1998 through 2003, the prevalence of obesity increased from 13.05% to 15.21%, and the prevalence of extreme obesity increased from 1.75% to 2.22%. • Obesity and extreme obesity among U.S. low-income, preschool-aged children went down for the first time in recent years, according to CDC’s first national study.

7. Smoking • Tobacco use is the leading preventable cause of death. Worldwide, tobacco use causes more than 5 million deaths per year, and current trends show that tobacco use will cause more than 8 million deaths annually by 2030. Cigarette smoking is responsible for about one in five deaths annually (i.e., more than 440,000 deaths per year). An estimated 49,000 of these smoking-related deaths are the result of secondhand smoke exposure. On average, smokers die 10 years earlier than nonsmokers.

8. Hypertension 67 million American adults (31%) have high blood pressure- that’s 1 in every 3 American adults. 69% of people who have a first heart attack, 77% of people who have a first stroke, and 74% of people with chronic heart failure have high blood pressure. More than 348,000 American deaths in 2009 included high blood pressure as a primary or contributing cause. About half (47%) of people with high blood pressure have their condition under control.

9. Cholesterol 71millionAmerican adults (33.5%) have high LDL, or “bad,” cholesterol.1 Only 1 out of every 3of those adults has the condition under control. Less than half of adults with high LDL cholesterol get treatment. Average total cholesterol level for adult Americans (mg/dL) 200 14.1% • Percentage of adults with high serum total cholesterol >240 mg/dL 2x • Risk of getting heart disease compared to adults with optimal levels

10. External Benchmarks • Data from Buck Consultants, one of the leading Global HR consulting firms who are known for their wellness benchmarking • Source: final report from their 5th annual global wellness survey entitled: “Working Well: A Global Survey of Health Promotion and Workplace Wellness Strategies” (November 2012) • 1,356 employers, from 45 countries, representing more than 17 million employees responded to the survey • Participants ranged from small employers to large multinational corporations, with an average employee population of approximately 14,700

11. Summary of Main Survey Results: Strategic Objectives • Top Strategic Objectives for Wellness Programs (U.S.) • Reducing health care or insurance premium costs • Improving worker productivity, reducing presenteeism • Reducing employee absence due to sickness or disability • Top Health Risks or Issues Driving Wellness Strategy (U.S.) • Physical activity, exercise • Nutrition, health eating • Chronic disease (e.g., heart disease, diabetes)

12. Summary of Main Survey Results: Program Components • Top Health Promotion/Wellness Program Components (U.S.) • Employee Assistance Program • Immunizations/flu shots • Health risk appraisal • “Nurse line” or other health decision phone support • Disease management programs • Fastest Growing Wellness Program Elements (U.S.) • Improving the psychosocial work environment • Health coaching (on-site) • Peer/social support (on-line or on-site) • Healthier vending machines • “Cycle to work” program

13. Key Findings/Statistics • General Findings • Organizations are going global • Responsibility for wellness and health promotion still falls under HR • More employers focus on “knowing your numbers” • Employers recognize value in extending wellness initiatives to family members of their employees • No single drive behind health care cost trend reduction • Communications and Culture • The top tool/channel that U.S. employers use to communicate wellness programs is web portal/intranet, followed by annual benefits enrollment materials and posters/flyers • Only 10% of U.S. employers use mobile technology as a tool/channel for wellness communications • Only 25% of U.S. employers believe they have a “culture of health” today (as defined as an organizational climate that promotes healthy lifestyle choices), but 81% plan to pursue this in the future

14. Key Statistics • Motivational Strategies • 88% of employers in the U.S. offer incentives (rewards, penalties, or both) to encourage participation in wellness initiatives • Top 3 types of rewards: raffles/drawings, cash, gifts/merchandise • Top 3 types of penalties: health insurance premium increases, mandatory participation, increased health copayments • Measurement and Financial Outcomes • Key challenge for employers continues to be measurement and validation of the effectiveness of their wellness programs • Only 35% of U.S. employers indicate that they have measured specific outcomes • 23% of U.S. employers indicate that their wellness program had an impact on trend (23% did not have an impact, while 54% did not know) • Of the 23% of U.S. employers who indicated their wellness program had an impact on trend, 62% reported reductions of 2% or more