The lengthy pandemic, ongoing racial injustice, and global economic turmoil have highlighted the inequitable health outcomes that marginalized and underserved communities experience in the US. They have also underscored the urgent need for help from the biopharmaceutical industry. Yet while many biopharma companies have tried to improve health equity, few have been able to effect change on the scale they envisioned.
BCG has developed an approach that biopharma leaders can use to increase the impact of their health equity efforts. Companies need to recognize health inequities and their root causes, understand the value of addressing these disparities, develop effective strategies, and build an operational framework to implement those strategies.
Health equity benefits not only patients but also organizations because of its ability to expand patient reach, improve employee value propositions, and enhance relationships with key stakeholders. In short, achieving health equity is critical for biopharma companies to move forward during this period of turmoil and beyond.
We define health equity as the elimination of disparities in medical access, treatment, and outcomes across populations. In the US, such inequities are disproportionately felt by populations that have long been victims of institutional and cultural racism.
Drawing on interviews with key leaders of biopharma companies and other organizations in the health care value chain, we have identified four steps that biopharma companies should take to address these disparities.
Recognize health inequities and their root causes. Numerous interconnected barriers to health equity exist throughout the patient journey, from disease identification to the ability to sustain care. (See Exhibit 1.) And many of them—in the form of the social, economic, and environmental factors that affect one’s health—are established long before a patient even begins to interact with the health care system. Given that these barriers are often unique to a marginalized group or community, listening to what the affected individuals have to say is critical in order to understand the root causes.
It’s also important to recognize that, since health equity barriers are interconnected and systemic, point solutions often fail to have the desired impact. Consider affordability, for example. Even if the barrier of cost were removed and all prescription drugs were available for free, other barriers would still prevent equitable outcomes. For instance, many patients would not be able to access a pharmacy easily, take their medication consistently, or get follow-up care.
Understand the value of addressing health inequities. Pursuing greater equity in health care provides real value for both patients and organizations. Leaders need to articulate the three types of value that health equity creates for their organizations in order to secure the necessary commitment and resources for effective initiatives:
Develop effective strategies. Even when companies understand the reasons that underly health care disparities, health equity initiatives frequently fall short of the intended outcomes. That’s often because the goals of the initiatives are so broad that they don’t address all the interconnected barriers.
To increase their chances of success, companies should tailor solutions to the fundamental barriers. They should choose a specific focus across four dimensions—patient journeys, disease states, geographic regions, and marginalized groups—and then address the barriers in each. (See Exhibit 3.)
Companies should make these choices on the basis of their greatest comparative advantages, such as expertise in a specific therapeutic area, strong relationships in specific geographies, operational strengths, existing partnerships, and unique leadership positioning. Gilead Sciences’ COMPASS initiative provides a useful example. COMPASS has a broad focus on the entire patient journey and a narrow focus on a disease state (HIV), a geographic region (the southern US), and marginalized groups (racial and ethnic minorities and gay and bisexual men).
Build an operational framework. After establishing a health equity strategy, a company needs to build an operational framework with the following five elements:
Achieving health equity is no easy task. And to effect real change, a biopharma company must be in it for the long haul. Organizations must avoid abandoning initiatives even if the disease state or therapeutic area focus shifts, because doing so will erode the trust that is essential for success.
Despite its immense challenges, health equity provides biopharma leaders with both an opportunity and a responsibility: an opportunity to help their organizations succeed in the future and a responsibility to address the health inequities that continue to harm marginalized and underserved communities.
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