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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
LiverCancerMortalityinUSHispanics
2nd LeadingCause(11%)
5th LeadingCause(6%)
CancerStatisticsforUSHispanics,2018CACancerJClini 2018
HepatitisCinPuertoRico
ü 1st CauseofLiverCancerü 1st CauseofLiverTransplantü 3%ofseroprevalance inPR>100,000infectedindividuals
ClinicalBenefitofPembrolizumabTreatmentAccordingtoMismatch-RepairStatusLeDTetal.NEngl JMed2015;372:2509-2520.
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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.