All things being equal

Going beyond diversity to create equity across pharma

The pharmaceutical industry stands to make significant gains from emphasising diversity across leadership teams and patient populations.

Anticipated advantages, however, could be rendered useless if equity is not also thoughtfully and deliberately planned for.

Diversity describes the state of factors within a specific group, including race, ethnicity, gender and identity, age, physical ability and sexual orientation.

In the pharmaceutical industry, diversity plays a critical role in multiple ways, from ensuring broad representation in clinical trials in order to validate drug efficacy across races and ethnicities, to changing the demographics of the boardroom and capturing a broad range of opinions and lived experiences for optimal decision-making.

Statistics show that companies with a more diverse workforce are more likely to achieve heightened profitability, illustrating invaluable synergy between inclusivity and financial success.

While diversity undoubtedly brings valuable perspective and innovation, equity is a critical component that must accompany any diversity initiative.

Diversity brings a rich array of experiences to the table, but equity is the guiding force that ensures there’s a seat in the first place.

In recent years, there has been a push to diversify patient populations in clinical trials. The research is clear – including predominately white male patients in clinical trials creates significant shortcomings in our scientific understanding of disease and treatment effectiveness across different populations.

To be successful, diversity initiatives to increase clinical trial participation in underrepresented populations must also take an equity approach.

Even by removing system-level barriers such as clinical trial availability, patient health literacy and enrolment qualification, persistent impediments remain.

Patients in underrepresented populations often have to travel farther to clinical trial sites, are less likely to have a family/friend accompany them for support and are more likely to mistrust health systems/physicians.

In fact, a systemic review by Ford et al. found mistrust to be the most pervasive barrier to clinical trial participation.

An equitable approach guarantees that socio-economic factors – outside of gender, race or ethnicity – are considered and adequately addressed in any diversity initiative.

So, how can pharmaceutical companies ensure true equity beyond diversifying patient populations?

Real-world evidence (RWE) offers a powerful vehicle to examine factors that influence true health equity. Because RWE includes an expansive scope and substantial longitudinal nature, it presents formidable advantages and efficiencies for conducting research on health equity.

Leveraging RWE provides researchers the opportunity to investigate treatment effects or access in populations that mirror real-world practice and encompass diverse groups often underrepresented in clinical trials.

It allows for the examination of larger sample sizes within socio-economic subgroups, enabling swift generation of insights for precise characterisation of underrepresented populations.

Analyses can delve into intricate networks of variables, including simultaneous exploration of multiple social determinants of health, their respective impacts and potential interactions.

It is this deep understanding of the complexities that underrepresented populations face that enable truly impactful and effective diversity initiatives in the pharmaceutical industry.

We must truly understand the underlying causes of healthcare inequities in order to develop solutions that address these issues in the most personalised way. 