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ThePuertoRicoChamberofCommerceandElNuevoDía present:

Research-Driven Health Policies to Ensure Health Equity

Marcia Cruz-Correa, MD, PhD, AGAF, FASGE

PuertoRicoHealth&InsuranceConference2019

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HealthEquityisthefairdistributionofhealthdeterminants,outcomes,andresourceswithinandbetweensegmentsofthepopulation,regardlessofsocialstanding.

WorldHealthOrganization

Healthequity”impliesthateveryoneshouldhaveafairopportunitytoattaintheirfullhealthpotential

LiverCancerMortalityinUSHispanics

2nd LeadingCause(11%)

5th LeadingCause(6%)

CancerStatisticsforUSHispanics,2018CACancerJClini 2018

AgeAdjustedIncidenceRatesLiverCancerPR(1987-2012)

HepatitisCinPuertoRico

ü 1st CauseofLiverCancerü 1st CauseofLiverTransplantü 3%ofseroprevalance inPR>100,000infectedindividuals

AccesstoMedicines=HealthEquity

ImmunoTherapiesinCancer

Dr.JimAllison,NobelPrice2018

AntiPDL1therapy– 1stcanceragnosticdrug

Longtermsurvivor

Complete&partialresponsesinStageIVCancers

ClinicalBenefitofPembrolizumabTreatmentAccordingtoMismatch-RepairStatusLeDTetal.NEngl JMed2015;372:2509-2520.

EnsureHealthEquitybyPromoting

InclusiveResearch

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PuertoRicoHealth&InsuranceConference2019

• FDArequiresthatpharmaceuticalcompaniessubmittingapplicationsfornewdrugsand/orindicationsforexistingdrugstoincludeparticipantsfromdiverseethnicandracialbackgroundsincludingHispanics

• Lessthan5%ofalloncologytrials includeHispanics

ParticipationofHispanicsinOncologyClinicalTrialsisLimited

FDAOncologyApprovals(2017)

https://www.fda.gov/drugs/informationondrugs/ucm412998.htm

Oncology:7,045 patients participated in trials that led to approvals of 12 new drugs

Demographic,Subgroups, Women, White, Asian,

Black,or,African,American,

Hispanic, Age,65,and,Older,

United,States,

Par@cipant,Average, 83%$ 74%$ 12%$ 2%$ 4%$ 26%$ 34%$

2017DrugTrialsSnapshotsSummaryStatistics(Jan1,2017- Dec31,2017)

ExpandedInclusion2018

TheAmericanSocietyofClinicalOncology(ASCO)

FriendsofCancerResearch(Friends)AdvocacyOrganization

OncologyClinicalTrialsinPuertoRico• 5,500 openandrecruitingoncologyclinicaltrialsintheUnitedStates,53(1%)areconductedinPuertoRico*

• 32sponsoredorco-sponsoredbypharmaceuticalindustry

• AnopportunitytostrengthenoncologyclinicaltrialsprogramsinPuertoRicotohelpfillthisgap

*Clinical Trials.gov Dec 2018

CancerinPuertoRico

ü1st causeofdeathüEveryyear>15,000newdiagnosisofcancersüOver50,000peoplelivingwithcancer

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PuertoRicoHealth&InsuranceConference2019

PuertoRico–ClinicalResearchEcosystem

•Hispanicpopulation• Solidinfrastructure

•Universities•HealthSystems•Professionals•Pharmaceuticals

•GovernmentInitiative(PRCCI)

ParticipationinClinicalTrials

Primaryreasonpeopleparticipate inclinicaltrials……Theywereasked

Primaryreasonpeopledonotparticipateinclinicaltrials…Theywerenotasked(notavailable)

ClosetheHealthEquityGapinPuertoRico

Provideaccesstoapprovedtherapies,measureoutcomes,andpromoteacultureof

research-drivenhealthpolicyandquality.

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Thank You

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