By Courtney Christian, Senior Director of Policy and Research, PhRMA
In the wake of transformative biopharmaceutical innovation and breakthroughs, Americans need a health care system that ensures these life-saving breakthroughs reach all patients.
Achieving health equity requires confronting disparities in health care accessibility and affordability, and actively rooting out systemic racism and biases that exist within our health care system.
PhRMA recently hosted a panel at Aspen Ideas: Health, Realizing the Promise of Health for All, which focused on tangible ways to improve health equity. As I listened to both real world-examples and lived-experiences that the panelists shared, and in reflecting on my own experiences, I came away with at least three actions needed to achieve health equity in our health care system.
1. We need to earn the trust of communities of color in the health care system.
Every day, people in underserved communities experience differences in treatment in our current health care system that have roots in longstanding medical mistreatment, but are reinforced by present day bias and racism.
On the panel, Genentech’s Chief Diversity Officer, Quita Highsmith talked about how our health care system needs to be more thoughtful about how physicians interact with patients of color, which has in some instances resulted in patients not receiving the complete care that they need.
For example, this is present even in the treatment of children who experienced emergency appendicitis surgery, with Black children sometimes being less likely to be offered pain medication.
To fix the inequities in our health care system, we need to show that the health care system truly cares about all patients with tangible actions, not just words.
2. We must expand diversity in clinical trials.
Clinical trials should be reflective of the population in which the research aims to serve.
Recently, PhRMA joined the Yale School of Medicine, Morehouse School of Medicine (MSM), the Research Centers in Minority Institutions (RCMI) Coordinating Center at Morehouse School of Medicine, and Vanderbilt University Medical Center launched Equitable Breakthroughs in Medicine Development, an innovative collaboration to increase diversity in clinical trials and address systemic barriers to participation by communities of color, so that patients who want to participate, can.
Equitable Breakthroughs in Medicine Development will help underrepresented patients be more involved in the research and development of potential life-saving medical treatments that will hopefully translate to improved health outcomes for themselves and their families. Funded by a grant from PhRMA, the initiative will work over the next 18 months to pilot a network of sustainable, connected, community-based trial sites.
3. We need to work to break down systemic barriers to accessibility and affordability within health care.
Even a patient’s zip code can be a determinant for the quality of health care they will receive.
Rural areas face accessibility barriers such as pharmacy closures, inadequate public transportation, and medical professional shortages. In over 40% of U.S. counties, people are required to drive at least 15 minutes to reach a nearby pharmacy. Rural states such as Kansas, Montana, South Dakota, and Nebraska have the largest number of counties with pharmacy deserts.
One-third of highly populated urban neighborhoods have poor access to a nearby pharmacy either due to distance or lack of transportation , leading to lower adherence rates to needed prescription medicines Black and Hispanic/Latino neighborhoods when compared with white or diverse neighborhoods .
Beyond location, a patient's socioeconomic status has a large impact on the ability for patients to access quality health care. For many Americans, even health insurance coverage does not provide them with health security – as 3 in 10 insured Americans still face financial barriers to care. Insurer-imposed practices (including prior authorization, fail first, exclusion from a formulary, among others) disproportionately impact minority populations.
We need to make insurance work by lowering out-of-pocket costs and expanding access to life saving treatments.
We must work together to build a more equitable health care system that works to serve all patients. The biopharmaceutical industry is making progress by working alongside patients, communities and state and federal legislators to make changes that improve our health care system.
Learn more about PhRMA’s Health Equity Initiative here: phrma.org/Equity
The views and opinions of the author are their own and do not necessarily reflect those of the Aspen Institute.