Pharmaceutical giant Eli Lilly and Co. is partnering with the National Minority Quality Forum, a non-partisan research and education organization focused on health equity, to propose steps to address health disparities. The partnership will initially focus on cancer care and eventually extend to other health conditions.
“Cancer is an area [where] there’s a lot of innovation happening,” Eric Dozier, Eli Lilly’s vice president of North American Oncology, said. “There’s an opportunity for us to improve overall care here, and there’s a need. So, this is a nice place for us to kind of start that dialogue relative to social determinants of health and make an impact.”
The partnership started in April 2021 and is still in its early phases. In addition to shining a light on existing problems, the two organizations are starting a dialogue with different medical and non-medical stakeholders and policymakers to improve health outcomes for Black and Brown patients.
Lilly and Washington, D.C.-based NMFQ recently published a report that outlines recommendations to tackle disparities in cancer care from screening to treatment.
African Americans have the highest mortality rates and the shortest survival periods from most cancers compared to all other racial groups. In 2017, more than 70,000 African Americans died of cancer in the U.S. and some of these deaths can be attributed to social and economic barriers — a legacy of systemic racism.
“The American health care system was segregated up until the late 1970s. African Americans couldn’t go into certain hospitals; medical associations didn’t allow African Americans in,” NMFQ President Gary Puckrein said.
“The legacy system is still there in a lot of ways. It wasn’t until the Affordable Care Act in 2009, that 48 percent of African Americans actually got access to health insurance … So imagine living with diabetes or cancer or any other disease, and you have no health insurance and limited access to Medicaid?” he added.
Puckrein said the “culture” of the health care system needs to change to become more patient-centered and less cost-centered to level the playing field and put optimal care for all patients ahead of focusing on financial risks
“The system thinks its purpose is managing financial risk,” he said. “You hear people talking about rationing care as if that’s an appropriate thing for a health care system to do. And unfortunately, when you start rationing, guess what happens? Minority populations, poor people, they get underserved and end up with higher death rates from cancer.”
One of the foremost issues the partnership aims to tackle is increasing representation of Black and Brown patients in cancer clinical trials to improve their health outcomes.
Studies show that 75 percent of patients face barriers to participation in a clinical trial because of their social and economic conditions — and Black and Brown patients are hit the hardest leading to poorer health outcomes and less effective treatments from some cancers.
For instance, fewer African American women are diagnosed with breast cancer but when they are, they die at a much higher rate and have far worse five-year survival rates. Research shows that the type of breast cancer affecting Black women has a worse response to widely used cancer drugs.
“Even just transportation to the trial site and then also how do we make sure that we engage more providers in the recruitment and retention?” Dozier of Eli Lilly said.
Among the recommendations that Lilly and NMFQ stressed in the joint paper is to offer incentives to foster integration between medical and non-medical services, such as housing and transportation, to address social needs that affect cancer patients’ health outcomes.
A recent survey of oncologists showed that 90 percent believe that factors like financial stability, access to food and social isolation affect their patients’ health outcomes.
According to the American Association for Cancer Research’s 2020 report on cancer disparities, 34 percent of cancer deaths between 25 and 74 in the U.S. could have been prevented by removing social and economic disparities.
Part of this disparity results in Black and Brown patients seeking less preventative care and cancer screenings that could otherwise help in early treatment and better survival rates and overall quality of life.
“I’ve been in the cancer field specifically in my job at Lilly going on my fourth year. We have amazing medicine. Amazing things that we can do, but at the end of the day if this doesn’t get to patients, we can’t really have the outcomes we want,” Dozier said. “And so to me, part of this is for us to say, ‘how do we start to kind of reimagine care?’ I think each of us is playing an important [role]. It’s just going to require more collaboration, more partnerships, more engagement.”
The partnership plans to continue to foster collaborations and conversations to bring about steps that would reduce cost, increase access, and foster trust and accountability.
Resources for cancer patients: Lilly Oncology Support Center works to help eligible patients secure affordable access to their life-saving medications.