Discover and read the best of Twitter Threads about #pharmacoequity

Most recents (9)

1/ 🧵 NEW Editorial.

In the latest issue of @JAMA_current, my mentor Michael Fine, Donna Washington and I were invited to discuss a new 📝 on disparities in SGLT2i and GLP1-RA use for diabetes and what it means for the field of #Pharmacoequity research.

jamanetwork.com/journals/jama/… ImageImage
2/ As has been discussed frequently over the last month with the insulin co-pay provisions in the #InflationReductionAct, >37 million people in the US have #diabetes.

Regrettably, underrepresented racial and ethnic groups folks have ⬆️ rates of diabetes.

jamanetwork.com/journals/jama/… Image
3/ Even with the ⬆️ rates of diabetes, Black, Hispanic, and Asian patients in the US have been shown to have lower rates of #diabetes treatment, especially with the newer drugs available such as SGLT2i & GLP1-RAs.

SGLT2: jamanetwork.com/journals/jaman…

GLP1: jamanetwork.com/journals/jama-… ImageImage
Read 8 tweets
1/ FRESH OFF THE PRESS: we looked at language barriers and postoperative opioid prescription use after total knee arthroplasty in @ERCSPjournal and found lower fill rates for pts with limited English proficiency tinyurl.com/tka2022. See thread🧵 below...
2/ Total knee arthroplasty is a common surgery to address advanced osteoarthritis. Racial minorities are less likely to undergo TKA and have higher complication/readmission rates
3/ We were interested in how limited English proficiency (LEP) was associated with TKA outcomes and specifically, pain management. Identifying disparities in medication utilization after TKA provides insight into barriers faced by vulnerable patient populations
Read 23 tweets
‼️ NEW Paper ‼️

In @JAMANetworkOpen, we found that VA patients with #AFib who experience homelessness had a 21% ⬇️ odds of receiving stroke-preventing anticoagulation (blood thinners).

Here's more on our journey to this #Pharmacoequity paper.

Link: ja.ma/3ODXdss

1/
Previously, if you looked up "homeless & atrial fibrillation" in PubMed, only 5 results came up.

This included a 2003 @JAMAInternalMed study that saw that Ohio Medicaid enrollees had ⬇️ use of warfarin if they had homelessness or inadequate housing.

ja.ma/3PFwj52

2/
We started digging into this in 2019, when 1st author, David Wilson, a PittMed student & Veteran, met with me for a summer research project.

We decided to use our national #AFib cohort to see if there was a relation b/w homelessness & AF treatment.

ja.ma/3ODXdss

3/
Read 12 tweets
1/ 🧵 NEW Paper!

As part of a special issue on 💊 costs & access, we wrote a broad review on “Pursuing #Pharmacoequity - Determinants, Drivers, and Pathways to Progress.

We talk social & health policy, research, patient & prescriber factors. 👇🏾👇🏾

Link: tinyurl.com/nvtamek8 Image
2/ Understanding the multilevel determinants that influence equitable access to medications (and trying to do so in <5000 words (!) was the goal of our review.

With so many factors out there, we know we only began to scratch the surface.

read.dukeupress.edu/jhppl/article/…

#Pharmacoequity Image
3/ A few topics we discussed:

🔴 Public transportation & geographic access to pharmacies

🔴 Income and wealth inequities

🔴 Research representation

🔴 Health insurance coverage (e.g., ACA & Medicare Part D)

🔴 Clinician bias & trustworthiness

🔴 Patient primary language
Read 6 tweets
NEW STUDY: Medicare could have saved up to $3.6 billion in 2020 if it bought 77 generic drugs at prices by Mark Cuban's @costplusdrugs prices! 💵💵💵

Published today in @AnnalsofIM with @bnrome @akesselheim via @PORTAL_Research

🧵
1. The @costplusdrugs launched in January 2022 selling generic drugs at the cost of manufacturing + 15% + $3 pharmacy fee + $5 shipping.

We compared the unit price for 89 of 109 drugs sold in February to what Medicare Part D plans paid in 2020 @CMSGov ...
2. We found that Medicare spent $9.6 billion on 89 generic drugs in 2020.

It could have saved up to $3.6 billion on 77 of the 89 drugs if it purchased them at the largest quantity sold by Mark Cuban's Cost Plus Drug Company.

The other 12 drugs ($1.5B) did not offer savings..
Read 13 tweets
💊💊 New Tweetorial Alert 💊💊
Please take a break from your #doomscrolling and read this thread. If you have an even longer break read the paper @NEJM: nejm.org/doi/full/10.10… 1/7
This paper is about #PartD & cancer. It is also about #pharmacoequity (shoutout @UREssien). Not the way we typically think about equity, though. This is about how screwed you are if you need cancer treatment and your treatment happens to be covered by #PartD and not #PartB. 2/7
Half of cancer drugs are covered by #PartD. Whether you get a pill versus infusion is based on your cancer type or subtype. For #breastcancer the preferred regimens for #HER2+ cancer are infused (#PartB); for HER2-, ER/PR+ cancer preferred regimens include a #PartD drug. 3/7
Read 8 tweets
1/ 🧵 Out today in @Health_Affairs.

On #Pharmacoequity and equitable access to novel #COVID19 treatment.

Led by future Dr. @rohankhaz, we dive into the challenges & opportunities in ensuring that patients and communities most affected by the pandemic can get the care they need.
2/ At risk of redundancy, we previously discussed the challenges in achieving #Pharmacoequity, including in the pandemic, noting, “…For example, treatment of patients with #COVID19 has revealed substantial inequities in access to life-saving treatments.”

jamanetwork.com/journals/jama/…
3/ That observation was supported by national CDC data from earlier this year, as well as a recent national analysis of Medicare enrollees that found that Black patients had a 23% ⬇️ odds of receiving monoclonal antibodies when diagnosed with #COVID19.

jamanetwork.com/journals/jama/…
Read 6 tweets
One of the points we made in our article last month (👇🏾) is that #Pharmacoequity extends beyond prescription drug access to the entire therapeutic cascade. A couple of interesting papers led by @ashwin_nathan & @ACFanaroff on TAVRs and #HealthEquity.

jamanetwork.com/journals/jama/…

1/
@ashwin_nathan @ACFanaroff @SameedKhatana @petegroen @jaygirimd @hmartinjulien @bnallamo In @CircOutcomes, the team examined socioeconomic & geographic factors of hospitals that developed TAVR (newer, less invasive treatment for aortic stenosis) programs and found that hospitals serving wealthier patients were ⬆️ likely to start programs.

2/

ahajournals.org/doi/10.1161/CI…
3/3 A month later, the team showed in @JAMACardio that zip codes with ⬆️ rates of Black & Hispanic patients and those with more socioeconomic disadvantages had ⬇️ rates of TAVR, adjusting for age and clinical conditions.

So much to be done in this space.

jamanetwork.com/journals/jamac…
Read 4 tweets
1/ NEW: Excited to share our Viewpoint in @JAMA_current: "A Policy Prescription for Reducing Health Disparities -- Achieving Pharmacoequity."

A 🧵 on what #Pharmacoequity is, why it should be a public health & policy priority, and how we can achieve it.

jamanetwork.com/journals/jama/…
2/ Ensuring that all individuals, regardless of race & ethnicity, socioeconomic status, or availability of resources, have access to the highest quality medications required to manage their health needs is paramount. This is what we call #Pharmacoequity.

jamanetwork.com/journals/jama/…
3/ The #COVID19 pandemic has brought health equity to the forefront, especially in how we ensure access to novel therapies, from antivirals like #remdesivir and #molnupiravir to the Covid vaccine...

But inequities in access to novel drugs are much more than a Covid problem. 👇🏾
Read 10 tweets

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