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The COVID-19 pandemic has exposed global health inequities and is driving life sciences companies to establish strategies and better leverage data to address systemic causes and improve equity in access to healthcare innovations, particularly in clinical trials.
One of the lasting legacies of the COVID-19 pandemic will be the magnifying glass it placed over health inequity across the globe. In the United States, we witnessed a disproportionate impact of the virus in minority populations, with both cases and deaths having an outsized impact in Black and Hispanic communities in particular.1 As treatments and vaccines came to life, challenges—such as limited funding, inadequate infrastructure, and logistic issues—exacerbated existing global healthcare access inequities and highlighted significant structural issues in equitable access to healthcare innovations.2 These challenges were not merely point-in-time. As of mid-2022, the World Health Organization reports that only 58 of 194 Member States reached the target of 70% population vaccination—with only 37% of global healthcare workers receiving a complete primary vaccination.3
The pandemic, along with the social and political climate in the West, accelerated many life sciences companies towards establishing global public policy positions on health equity as well as specific strategies to address the underlying systemic causes. These initiatives aim to not only reflect the global health missions of life sciences companies but attempt to address the realities of health inequity on the economics of healthcare delivery. Estimates of the total cost of health inequities in the U.S. alone top $1 trillion by 2040 (a number which takes into account increasingly unhealthy populations as well as delayed diagnoses and treatments in underserved populations), which threatens the overall affordability of healthcare and pace of innovation.4
For life science companies, this responsibility and subsequent opportunity often is most clearly under focus in the clinical development cycle. Collectively, the industry has recognized that inequities in treatment access often begin in clinical trials and extend throughout the product life cycle. Challenges that can arise include:
Life science companies are attempting to address these clinical development inequities in a variety of ways, from standing up top-down pervasive initiatives to promote diversity and inclusion in their own ranks, to relying on task forces and external partnerships to address the lessons learned from the global innovation infrastructure challenges revealed from the last three years. In clinical development, several companies (such as Bristol Myers Squibb5 and Merck6) have recognized the lack of minority clinical trial staff (at sponsors, CROs, and sites) can have an outsized impact on bringing minority populations into clinical trials. In turn, they have made significant investments to increase minority investigators in leadership roles in clinical trials, supporting the development of minority investigator careers, and engaging with minority-serving institutions such as historically black colleges and universities to identify and recruit minority investigators.
In this age of explosion in clinical data availability, real-world data (RWD) such as like claims, electronic health records, and consumer insights can also play a significant role in supporting clinical development health equity initiatives and population understanding, such as:
Across the landscape, it’s of critical importance that we as an industry reflect on the lessons learned over the last three years and use all our tools to engage in this moral imperative to ensure each patient (no matter their age, race, creed, location, or gender) receives the best possible care. There is much work to be done to correct the systemic social issues that underlie these health inequities, but the progress happening right now rivals any other time in our industry’s history.