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Racial Disparities Persist in Retinal Disease Care


Race-based disparities in the U.S. healthcare system continue to persist, driven by a complex set of root causes. Solving these disparities is not an easy task and will require cooperation from many stakeholders – providers, payers, industry, public health officials, patient advocacy groups, and many others. All of these stakeholders need to be able to see the problem clearly and have the ability to measure improvements over time.

Quantifying Inequity to Preserve Sight

According to new research I’ll be presenting this week at the Pharmaceutical Management Science Association (PMSA) 47th Annual Conference, a trend we’ve been observing for years at Komodo Health, is rearing its head in yet another therapeutic area. The research analyzes prevalence and treatment patterns for retinal disease among Black and White patients in the U.S. It finds that Black patients are more likely than White patients to experience adverse outcomes and less likely to receive recommended treatment. 

While these findings are consistent with other analyses of race-based disparities in care that we’ve conducted using our Healthcare Map™ to track real-world patient journeys, the scale of the disparity and the quality-of-life implications they reveal are striking. 

Specifically, our research looked at patients over age 65 with diabetic retinopathy (DR) and diabetic macular edema (DME). Both conditions are widely known to affect communities of color disproportionately. On average, studies have shown that Black and Hispanic/Latino patients are roughly two to three times more likely than White patients to develop DR and DMA. 

Our research corroborated that trend and went deeper into treatment patterns among Black and White patients. We found that Black patients diagnosed with DR were 25% to 33% less likely to be treated with anti-VEGF medications (injections that slow the growth of blood vessels in the eye, which can lead to blindness) and 44% to 64% less likely to be treated with Eylea (the most commonly prescribed anti-VEGF therapy of the drugs approved by the FDA for this indication). Among those with DME, we found that Black patients were 20% to 30% less likely to receive any type of anti-VEGF therapy and 40% to 60% less likely to be treated with Eylea than White patients.

Unnecessary Suffering

The reason this disparity is so frustrating is that advances in the science of eye care over the past decade have made it possible for DR and DME patients to experience significantly better outcomes if they receive the right treatment. These anti-VEGF medications, which have been proven to help patients with advanced retinal disease keep their sight for many years, have made significant improvements in the treatment of a range of retinal conditions that can cause truly debilitating outcomes. Yet Black patients are less likely to get them.

Despite widespread availability of life-altering treatments and a constant refrain from healthcare stakeholders on the importance of incorporating diversity, equity, and inclusion into clinical practice, the real-world experience of patients from underrepresented racial and ethnic groups continues to be sub-optimal.

For our part at Komodo Health, we hope that by shining a spotlight on the issue using our software and analytics to expose gaps in care, we will help guide and measure the impact of practical solutions that will reset the status quo.

Find out more information about Komodo’s presence at PMSA.

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