COVID-19 Generated Scientific Momentum; will it Transfer to Other Chronic Conditions? | Deloitte US has been saved
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By Margaret Anderson, managing director, Deloitte Consulting LLP
COVID-19 highlighted long-standing inequities in health care. It also demonstrated that science is capable of moving quickly when necessary. As we emerge from the pandemic, health care stakeholders should take advantage of this momentum. We should apply the knowledge gained during the development of COVID-19 vaccines and therapies and apply it to other infectious illnesses, cancers, and rare diseases. We can’t go back to business as usual.
Prior to joining Deloitte, I helped to shape FasterCures, which is the Milken Institute’s non-profit biomedical-research-focused center. FasterCures is typically seen as an aggregator, a convener, a connector, and an accelerator that has pushed medical research to the next level by bringing multiple stakeholders together and putting patients at the center of it all. Last month, I participated in a panel discussion at the Milken Institute’s Future of Health Summit where I was joined by current and past leaders of FasterCures and related organizations. We reflected on some of the challenges we have overcome in the past and discussed opportunities the pandemic might have created for the future.
RWD and health equity
In recent years, real-world data (RWD) has revealed that health outcomes for most chronic conditions—from diabetes to cancer to mental health issues—can be profoundly influenced by geography, income, race, and ethnicity. Greg Simon, who previously headed the White House Cancer Moonshot Task Force, said the pandemic brought health equity into full view because so many essential workers were under-represented minorities and women. As my colleagues Asif Dhar and Kulleni Gebreyes noted in a blog last summer, Black Americans are more than twice as likely to die from COVID-19 than white Americans.
On his first day in office, President Biden signed an executive order to advance racial equity and support for underserved communities.1 The next day, he issued another executive order directing the federal government to address health equity in responding to, and recovering from, the pandemic.2 Since then, Federal agencies have been taking a close look at the role they can play in addressing issues around equity.
FasterCures has worked to address racial, economic, and gender disparities in health care for years. In the organization’s early days, Greg noted that researchers typically didn’t seek information directly from patients. Today, that type of RWD is critical for understanding patients, diseases, and therapies. Esther Krofah, the current executive director of FasterCures, said the pandemic experience, combined with RWD, could help ensure that medical innovation becomes more inclusive for patients with all types of conditions and from all types of communities. She suggested we have entered “a golden era of science,” but cautioned that not everyone benefits from that science, which is an issue that should be fixed.
Since the beginning of the pandemic, data scientists and researchers have been engaged in efforts to capture and analyze RWD to understand the nature of the disease and the efficacy of drugs to treat it. The Reagan-Udall Foundation’s COVID-19 Evidence Accelerator, for example, brought together major data organizations, regulators, and academic researchers to look for ways to convert RWD into actionable insights, according Deloitte’s recent report on Measuring the return from pharmaceutical innovation 2020.
Diversity in clinical trials
The need to improve diversity in clinical trials is not new. We’ve been talking about the importance of recruiting women and ethnically diverse populations for decades. Now this critically important issue is becoming a priority for many stakeholders. Moreover, regulators, biopharmaceutical companies, patient advocacy groups, and philanthropy organizations recognize that structural racism can have an enormous impact on health outcomes. Last fall, the National Institutes of Health (NIH) announced a program to provide outreach and engagement efforts in ethnic and racial minority communities that have been disproportionately affected by the pandemic. The NIH Community Engagement Alliance (CEAL) Against COVID-19 disparities, works closely with communities hit hardest by the pandemic.3
In September, the Deloitte Center for Health Solutions and the Pharmaceutical Research and Manufacturers of America (PhRMA) will publish a detailed report about clinical-trial diversity. The report is based on a two-day workshop of 500 stakeholders from 150 organizations representing industry, health systems, academic institutions, government entities, the faith community, and others interested in clinical trials. Enhancing clinical-trials by including participants from diverse populations can help sponsors ensure that their products and services are accessible to all populations, while simultaneously examining potential bias in tools and algorithms that may be perpetuating inequalities. Diverse representation of patient populations in clinical trials can also help to build public confidence in tested therapies once they become available.4
Progress and challenges in addressing disease
Across the US and around the world, COVID-19 demonstrated that we are all harnessed together in a way we couldn’t have imagined before the pandemic. Here’s a look at some of the issues we discussed during our session that relate both to the pandemic and our progress against all diseases:
I don’t believe scientific advancement can go back to where it was before the pandemic, and I expect other disease communities will try to take advantage of the momentum the pandemic generated. We have witnessed what is possible in terms of science, drug discovery, collaboration, regulatory approval. Esther said we have reached a perfect moment to remove health inequities in health care and biomedical research. “We can build a path toward a better future where biomedical innovation is inclusive of all patient types,” she said. “We need to make sure that everyone benefits from science. That hasn’t always been the case.”
1. Executive order on advancing racial equity and support for underserved communities through the federal government, The White House, January 20, 2021
2. Executive order on ensuring an equitable pandemic response and recovery, The White House, January 21, 2021
3. NIH to invest $29 million to address COVID-19 disparities, NIH press release, April 29, 2021; NIH Community Engagement Alliance (CEAL) Against COVID-19 Disparities
4. Racial diversity within COVID-19 vaccine clinical trials, Kaiser Family Foundation, January 26, 2021
5. Antibodies to SARS-CoV-2 in All of Us research program participants, January 2-March 18, 2020, Infectious Diseases Society of America, June 15, 2021
6. Rich countries cornered COVID-19 vaccine doses, Science, May 26, 2021