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Pharm Exec spoke with the senior vice president and vice president and therapeutic area head of global medical, inflammation & representation in clinical research at Amgen about how important health equity is to the entire industry.
Health equity continues to be a key focus of the life sciences industry. Ian Thompson, senior vice president and general manager for US business at Amgen and Ponda Motsepe-Ditshego, vice president and therapeutic area head of global medical, inflammation & representation in clinical research, spoke with Pharm Exec about how much work it takes to actually improve health equity and the importance of the results.
Pharm Exec: How important is it to have a global policy position on health equity?
Ian Thompson: Our industry is uniquely positioned to eliminate persistent health disparities and pave the way for true health equity.It is vital that global policies and practices support and advance health equity so that all people have an opportunity to be as healthy as possible.Health equity isn’t just a matter of public policy or healthcare delivery; it must be woven into the fabric of everything we do. To overcome access challenges and improve care capabilities, policies should underscore patient support programs, responsible pricing structures, financial assistance programs, and health systems strengthening.
It's also important that we embed health equity across the pharmaceutical value chain. From a market growth perspective, we should prioritize therapies for conditions with high unmet need to address health disparities present in our communities, particularly in key therapeutic areas such as oncology, cardiovascular disease, and inflammation. The statistics are staggering. For example, nearly half of all Black American adults have some form of heart disease and are 32% more likely to die from cardiovascular disease.1,2 Black patients also have a higher prevalence of CVD risk factors (including dyslipidemia, hypertension, diabetes, and obesity) compared to White patients.3 It’s clear we still have work to do.
How can life sciences companies implement corporate level statements on health equity at the product level?
Ponda Motsepe-Ditshego: In 2021, Amgen added environment, social and governance (ESG) performance targets to our company goals within our annual incentive compensation plan, ensuring employees are held accountable for improving health equity efforts. Our ‘Healthy People’ pillar is focused on improving health literacy, increasing the representation of racial and ethnic minority patient populations in clinical trials, and strengthening community and care support systems that impact access to healthcare for underserved communities.Once elevated to the corporate level, health equity principles can be applied across the full life cycle of therapeutics. Ensuring access can begin years before a product is approved, starting with clinical trial development. Clinical trials have lacked diversity for decades. Clinical trial diversity should be an industry-wide imperative; the more clinical trial participants reflect the diversity of the patient population, the more we can understand the safety and effectiveness of the products. Amgen’s Representation in Clinical Research team gathered insights and perspectives from representatives of historically underserved and excluded communities through a series of product-agnostic community advisory boards to develop an enterprise-wide framework to strengthen our focus on enhancing diversity and representation in clinical trial participation across our portfolio.
Our industry needs to evolve the way we design and run trials and bring the research directly to the communities where people live and work to build sustainable, trusted relationships with underserved populations. This research is complex and multidisciplinary and there isn't a single accelerator that can be used to address the systemic issues that deter people from participating. However, we do know we can help move the needle by engaging with patient-focused advisory councils to inform clinical trial design and execution, building enrollment support capabilities, including providing transportation, and measuring and evaluating best practices for improvement in enrollment of participants from diverse racial and ethnic backgrounds. This past year, Amgen worked with the American Cancer Society Cancer Action Network to test a trial eligibility screening intervention intended to increase and diversify patient enrollment in cancer clinical trials, including navigators to help patients address logistical and financial challenges to enrolling and completing those clinical trials.
When addressing health equity, when should companies start looking for partnering strategies?
Ian Thompson: Collaboration needs to happen at the beginning of an initiative–it can’t be an afterthought. We want to ensure that everyone who needs medicine gets access to it; that’s my personal mission and why I joined the industry. No one individual, organization, company, or government can address generations of health inequity alone. Industry, advocates, providers, community partners, and others should work together to ensure that quality, affordable healthcare and treatments are equally accessible. These partnerships should be both external and internal, including local organizations that have trusted relationships and credibility with the populations of focus and internal staff that have a large stake in health equity.
What pieces of data can best be used to measure health equity strategies?
Motsepe-Ditshego: We build measurement into all our programs to allow for ongoing refinement and improvement. In terms of achieving health equity in clinical trials, we can analyze the characteristics of trial participants, including race, ethnicity, sex, gender identity, age, socioeconomic status, disability, pregnancy status, and lactation status. On a broader scale, we need to look at public health surveillance data on the prevalence of chronic disease in certain populations, access and use of healthcare services, and social determinants of health.
What are the best ways for companies to coordinate across functions when implementing health equity strategies?
Motsepe-Ditshego: Executives and boards of directors need to make health equity a priority at the corporate level. Direction-setting from the top puts health equity strategy directly into practice and sets the tone for the entire organization. Building a top-down framework facilitates the ability to address interconnectivity in a holistic way and align activities across functions more closely with a company’s long-term health equity strategy. Internal company committees that oversee health equity should include experts from R&D, operations, sales and marketing, regulatory, medical affairs, and data and analytics, and be informed by employee resource groups that address health disparities. Amgen has several employee resource groups that promote and support diversity, including the Amgen Black Employee Network, Amgen Latin Employees Network, and Amgen PRIDE–LGBTQ and Allies Network.