Without key, cross-silo information, employers that implement medical cost controls via pharmacy plan design for employees run the risk of discouraging treatment essential to employees’ health-related productivity and quality of life. This IBI study, relying on a master database furnished by Ingenix, demonstrates the unanticipated consequences in increased short-term disability and lost productivity for rheumatoid arthritis (RA) that can occur when employers increase out-of-pocket expenses for necessary medications. If new “value-based benefit designs” are truly going to add demonstrated value, they must draw treatment, cost and impact links across traditional benefits lines through an integrated database.