Rite Aid, a top retail pharmacy chain, awarded its first Fill Up & Fuel Up gasoline gift cards this week.

I’ve been writing about gas ‘n health care since the inception of the Health Populi blog; see this inaugural post.

Now comes a pharmacy connecting the dots between consumer spending categories: the interdependency of fuel and prescription drugs.

As the differences between price tiers of prescription drugs have increased over the past ten years, I’ve often asked pharma clients the question: what is the consumer’s marginal value of that $20 (or $30 or $50) co-payment compared to something else on their shopping list — say, a new electric razor for their husband, or that $95 jar of anti-aging skin cream?

While confronted with smirks several years ago, no more. Rite Aid gets this.

They’re giving $30 gas debit cards with the transfer of a prescription to their store. If the Rx stays with Rite Aid, consumer’s name stays in play to win the gas lottery — a $2,600 gas card.

Rite Aid’s in 31 states with about 5,000 outlets. This game can’t be played in New Jersey or New York due to regulations in those states.

There’s another different sort of “Gaming for Meds” story to discuss. Aetna is sponsoring a study to see if a lottery can enhance patients’ adherence to prescribed drugs. The Aetna Foundation funded a Universtiy of Pennsylvania team to use prizes of $0 and $100 to reward consumers to take drugs as prescribed. An electronic monitor (the Med-E-Monitor) will track whether 100 participants are taking their warfarin. 50 patients will be enrolled in the lottery with a 1 in 10 chance of winning $10 a day, and 1 in 100 chance of winning $100. A text message will be sent each day to tell the patient whether he/she won the lottery, or if the dose wasn’t taken, whether they would have won the money. 50 people in the control group will be using the electronic monitor but won’t be incentivized with the lottery game.

The rationale? Medication adherence is a real problem in health care. It costs the U.S. $177 billion annually in direct and indirect costs, according to the National Council on Patient Information and Education. Results of the U-Penn trial will be out in spring 2009.

Health Populi’s Hot Points: The Rite Aid and Aetna stories represent two major health stakeholders confronting consumer realities, and doing something creative to meet the consumer where she lives: in the real world, paying megabucks at the pump and @retail in general. In the case of the U-Penn pilot, it will be instructive to learn the outcome next spring. Some health plans are already dropping Rx co-pays for selected chronic care medications to increase patient adherence. Those doing so have found that they can achieve real ROI as fewer enrollees show up at emergency rooms for care, and as employers see their employees appear (and be more ‘present’) at work. The roots of this are in the famed Asheville project.

Furthermore, the theme of games is growing in importance in health. Take a look at the Robert Wood Johnson’s Games for Health program. People like games, and here’s another way those organizations who serve patients can become part of their lives in more engaging and constructive ways. Dare I say — even fun?!