In the United States, the reality of healthcare disparities means that the healthcare one receives may be influenced by things like where a person is from, what they look like, their income, or even who they love All these factors play a part in perpetuating healthcare disparities, affecting countless Americans.  

The CDC defines health disparities as “preventable differences in the burden of disease, injury, violence, or opportunities to achieve optimal health experienced by socially disadvantaged racial, ethnic, and other population groups and communities.” Put simply, health disparities can stem from health inequities—systematic differences in the health of groups and communities occupying unequal positions in society that are avoidable and unjust

Systemic challenges like these require a collaborative effort from all aspects of the healthcare system. There’s a lot to do between addressing social determinants of health, economic stability, access to healthcare, and health literacy. Thankfully, the work has begun. 

The Centers for Medicare & Medicaid Services (CMS) has a deep commitment to advancing health equity. 

What they’re doing: CMS created a new law that mandates Medicaid cover and reimburse routine costs for qualifying clinical trials.  

Why it matters: Reevaluating laws can increase the number of low-income or disabled participants and improve the validity of clinical trials to “help reduce disparities in treatment outcomes for people with life-threatening diseases.” 

What they’re doing: CMS is prompting health plans to incorporate health equity into plan structure and communicate “how health equity is accounted for in care delivery to members” and how diverse and inclusive their staff is. 

Why it matters: Integrating health equity helps identify where changes are needed and where services should be provided. 

What they’re doing: Policymakers are considering changes to Medicare Part D benefit designs in the form of a cap on out-of-pocket spending for Medicare enrollees. 

What it matters: An Avalere analysis found that certain underrepresented populations, including Black, Hispanic, and disabled enrollees, would benefit to a higher degree than other enrollees. 

Health systems are on the front line of patient care and identifying health disparities.  

What they’re doing: Memorial Sloan Kettering (MSK) created the Affordability Working Group—a multifunctional team to help address financial issues for cancer patients that is piloting a screening tool to assess patient financial toxicity proactively. 

Why it matters: Almost a quarter of MSK patients have experienced financial hardship, but most providers do not learn about the issue until patients stop taking their medication due to cost. This is especially prevalent in underserved populations. 

What they’re doing: A cancer surgeon and colleagues at MSK met with a pharmaceutical manufacturer to raise concerns about the dosing of their product and how the current structure would lead to high out-of-pocket costs for specific patient populations. 

Why it matters: Collaboration between health systems and pharmaceutical manufacturers can lead to changes that benefit traditionally marginalized patient populations. 

How can pharmaceutical manufacturers help? 

What pharmaceutical manufacturers could be doing: While pharmaceutical manufacturers need to continue engaging with the broader healthcare system to help address healthcare disparities in the long term, there is action they can take now. Pharmaceutical manufacturers can help facilitate economic health care literacy by creating patient resources and materials for health systems and HCP partners that address existing gaps in health care.  

Why it will matter: Finding the right partners to help develop or implement programs and materials that allow health systems to 1) identify patients who need support, 2) provide the programs and services they need, and 3) present their findings to the larger healthcare community to help ensure that marginalized communities are not denied the healthcare they need.  


About the Author:

Sara Rubin has over 19 years of pharmaceutical experience, with a focus on brand strategy, launch readiness, market access, and account manager strategy and initiatives. She’s led market access work in areas such as contracting, pricing, distribution, and market research, and helped develop strategic programs including value-based contracts, launch readiness plans, and payer value messaging. Sara has in depth experience in specialty and rare diseases, as well as a background with medical/Part B and pharmacy/Part D drugs. As a Managed Markets Strategist, Sara is focused on providing subject matter expertise to support both in-market and pre-launch brands to develop market access plans for population health decision makers.

Prior to joining Syneos Health, Sara held market access, marketing, and sales roles on the pharmaceutical side, including 7 years with Solvay Pharmaceuticals and over 6 years with Eli Lilly and Company. Sara led several launches and gained experience in oncology, men’s health, and cardiovascular health.

Sara has spent the last 10 years focused on oncology market access. She led the thoracic market access team at Lilly focused on Alimta and launched Portrazza. Sara has created market access strategies in over a dozen cancer types across solid tumors and hematology.