Utibe R. Essien, MD MPH Profile picture
Oct 22, 2021 10 tweets 9 min read Read on X
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. 👇🏾
4/ So how can we achieve #Pharmacoequity? We propose 3 key policy areas that we should focus on:

🔶 Increasing Access to drugs
🔶 Reducing Cost of drugs
🔶 Improving Quality of drugs

Here's what we mean.👇🏾

(Keep scrolling, you're halfway through! 😃)

jamanetwork.com/journals/jama/…
5/ First, we must reimagine "access." This includes:

1. Adopting universal, low-cost prescription drug coverage
2. ⬆️ geographical access to pharmacies
3. ⬇️ bias in specialist referral & novel drug prescribing
4. ⬆️ representation of underrepresented groups in clinical trials
6/ Second, we need a commitment to ⬇️ rising drug costs.

Many solutions to ⬇️ cost exist, but we believe that analyses of prescription drug prices & drug coverage policies need an *equity impact analysis* to examine the effect of all novel drugs on reducing health disparities.
7/ Lastly quality improvement programs should prioritize #Pharmacoequity as a key part of QI measures.

We can do this by standardizing disparities data collection, intervening on known prescribing disparities, tracking & reporting equity improvements, and sharing best practices.
8/ There's so much we didn't get to in 1200 words, including the urgent need to address equity globally.

Also, while #Pharmacoequity is key, it alone can't achieve health equity w/o addressing the policies that have kept certain groups w/o the resources needed to live healthily.
9/ Many thanks to @walidgellad & @DusetzinaS, two of the smartest people I know studying drug policy, for helping bring my #Pharmacoequity vision to the page.

For more on our piece & another great JAMA Viewpoint out today check out our podcast convo. 👇🏾

edhub.ama-assn.org/jn-learning/au…
@walidgellad @DusetzinaS 10/10 We're in early stages, but really looking forward to working with @PittCP3 and the @PittTweet community to host our 1st-ever Pharmacoequity Conference here in Pittsburgh next Spring! Stay tuned!

cc @oni_blackstock @ashishkjha @DrAlethaMaybank @EbonyJHilton_MD @RheaBoydMD

• • •

Missing some Tweet in this thread? You can try to force a refresh
 

Keep Current with Utibe R. Essien, MD MPH

Utibe R. Essien, MD MPH Profile picture

Stay in touch and get notified when new unrolls are available from this author!

Read all threads

This Thread may be Removed Anytime!

PDF

Twitter may remove this content at anytime! Save it as PDF for later use!

Try unrolling a thread yourself!

how to unroll video
  1. Follow @ThreadReaderApp to mention us!

  2. From a Twitter thread mention us with a keyword "unroll"
@threadreaderapp unroll

Practice here first or read more on our help page!

More from @UREssien

Apr 17, 2023
1/ 🧵 NEW Paper.

We asked: Are there racial & ethnic differences in barriers to applying to & enrolling in med school and do those affect med school diversity?

TL;DR: Black & Hispanic students were less likely to apply & enroll and faced more barriers.

jamanetwork.com/journals/jama-… ImageImage
2/ First, who did we study?

This was a study of >81,000 MCAT examinees (0.3% American Indian or Alaska Native, 21.3% Asian, 10.1% Black, 8.0% Hispanic, and 60.4% White) from 2015-2018.

I don’t know about y’all, but this was *the* hardest test I took. 😳

jamanetwork.com/journals/jama-… Image
3/ Next, what did we find?

1️⃣ Black (77.8%) & Hispanic examinees (71.3%) were ⬇️ likely than White examinees (80.2%) to apply to med school.

Black (40.6%) & Hispanic examinees (40.2%) were also ⬇️ likely than White examinees (45.0%) to matriculate.

jamanetwork.com/journals/jama-… Image
Read 12 tweets
Sep 8, 2022
Wow. 😧

If y’all read *one* thing today, might I suggest this new article in @NEJM?

“The belief that Black people have denser bones, more muscle, or thicker skin led radiologists and technicians to use higher radiation exposure during x-ray procedures.”

nejm.org/doi/full/10.10…
Read 5 tweets
Sep 7, 2022
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
Jul 27, 2022
‼️ 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
Jul 25, 2022
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
Feb 10, 2022
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

Did Thread Reader help you today?

Support us! We are indie developers!


This site is made by just two indie developers on a laptop doing marketing, support and development! Read more about the story.

Become a Premium Member ($3/month or $30/year) and get exclusive features!

Become Premium

Don't want to be a Premium member but still want to support us?

Make a small donation by buying us coffee ($5) or help with server cost ($10)

Donate via Paypal

Or Donate anonymously using crypto!

Ethereum

0xfe58350B80634f60Fa6Dc149a72b4DFbc17D341E copy

Bitcoin

3ATGMxNzCUFzxpMCHL5sWSt4DVtS8UqXpi copy

Thank you for your support!

Follow Us!

:(