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