By Michael CasoBiopharmaceutical companies pride themselves on conducting comprehensive research activities. These research initiatives could be clinical programs to determine the viability of a new chemical entity to satisfy an unmet medical need, market access programs, or more recently, patient-centric needs of targeted populations. Why then have these same companies virtually ignored the medical, social and cultural needs of the fastest growing segment of the U.S. population?
Ethnic and racial minorities currently comprise over 30 percent of the U.S. population and will grow to 50 percent by 2050. In fact, in many geographical areas, minority populations represent an “emergent majority” — a collective majority of minorities. Additionally, this population can have unique responses to medications and are differentially impacted by a number of common disease states for which they are diagnosed later and have poorer control or survival rates than majority populations. It would appear that there exists here a nexus of needs and opportunities that should appeal to the biopharmaceutical industry, where a focus on a medical need can result in a healthier population and a healthier bottom line. This is the first of a three-part posting that will provide supportive data that identifies the need, demonstrates targeting opportunities and provides specific strategies and tactics designed to positively impact complementary health disparity reduction and business goals. Opportunities for Targeting: Disease States and Geography Disease States Disparities in healthcare are evident in the diagnosis and treatment of specific health conditions, in the utilization of preventive services and in health outcomes. These disparities may be caused by unique reactions to medicines, cultural or social factors. In fact, the majority of published research indicates that minorities are less likely than whites to receive needed services. In Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care, the Institute of Medicine (IOM) of the National Academies, reports: African-Americans and Hispanics tend to receive a lower quality of healthcare across a range of disease areas; disparities are found across a range of clinical settings; and the disparities in care are associated with higher mortality among minorities. Any institution that impacts public health — academia, medicine and social services, etc. — has a role to play in reducing disparities in healthcare; pharmaceutical companies are no exception. It would be challenging to find a pharmaceutical company without a product in at least one of the core six disease states identified by the U.S. Department of Health and Human Services (HHS) Office of Minority Health (OHM), in which racial and ethnic minorities experience serious disparities in health access and outcomes, as well as other diseases which differentially impact minority populations:
In addition, the following diseases and conditions disproportionately impact racial and ethnic minorities: Disease Disparities Mental health
While providing a tremendous service by addressing critical unmet medical needs, pharmaceutical companies will expand business opportunities by reaching minority populations. Analyzing and communicating data about these markets can improve pharmaceutical company efforts in improving outcomes and delivering assistance to the healthcare system through improved population management. The improved outcomes and population health management assistance will increase product demand, enhance relationships with growing physician and patient populations, and lead to networking opportunities within governmental health agencies, ethnic medical associations and community-based organizations. Geography While a focus on specific disease states is critical, so too is the ability to impact specific population bases. In this manner, it is more likely that limited resources can have a significant and measurable impact that can then be duplicated in other areas of need. Historically, significant minority population bases exist in major metropolitan areas. Wikipedia, as well as government census reports provide listings of cities for black, Hispanic and Asian populations and these tables can be used for creating an initiative for a single population. However, if your goal is to have a comprehensive initiative across all three of these minority groups, a comparative analysis of metropolitan areas would be required. A suggested list of targeted cities for initiatives impacting black, Hispanic, and Asian populations would include the following:
Developing a Plan for Engagement and Collaboration Now that we have addressed the why, what and where, let’s review options for how. The development of any plan for engaging minority physicians and patients should exhibit a number of key characteristics:
Proposed Strategies and Tactics Having provided the characteristics listed above, the following are suggested strategies along with associated tactics:
As the U.S. population demographics shift, so too must the focus of the pharmaceutical industry. As stated previously in this publication, there exists here a nexus of needs and opportunities with minority populations, where a focus on a medical need can result in a healthier population and a healthier bottom line.
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