As healthcare information has achieved ubiquity in our lives, so, too, have reports about clinical trials of new, potentially lifesaving drugs.
There are, in fact, three conversations happening at once about clinical trials. One is on the clinical side, and in these discussions the talk is about protocols and data, crossover design, arms and controls. It is technical and expertise-based.
There’s another conversation going on in which some hopes are raised and others are dashed as study results are made public by the media. This conversation — made possible by the democratization of healthcare information — is about whether a new blockbuster drug will succeed and the disappointment of failure.
But I’ve also found a third conversation about the clinical studies that actually gets to one of the most profound aspects of our healthcare system: access. Who is included in trials, who is excluded, what does that mean and what we can do?
Unfortunately, “when there’s a rumor that a new drug is hot, if it is being offered, upper-class Americans with good insurance will fly to the medical center, stay in a hotel, get on the trial.” That’s part of the concern expressed by Dr. Otis W. Brawley, chief medical officer of the American Cancer Society in the New York Times article “In Cancer Trials, Minorities Face Extra Hurdles.”
Overall, the participation of minority groups in clinical studies is not only low, but it’s disproportionate with the percentage of a group’s members in the general population.
There are multiple reasons: lower incomes which are a barrier to travel, less education leading to lower awareness, and other chronic diseases in groups which can make them ineligible for study participation.
In studies conducted by the National Institute of Health, the law requires that any trial include women and minorities. But most studies aren’t conducted by the NIH; in fact in 2014, only 6% of trials were conducted by the government entity. That leaves a vast number of important studies in which women and minorities aren’t participating at significant levels. Excluding or having minute diversity participation can lead to unequal care and higher death rates as well as inadequate science.
It’s not a silent problem, and people are working at it. Investigators, academics and policymakers are exploring ways to increase diversity in clinical studies. But it’s a significant problem still.
Here’s another way at it: marketing. As healthcare marketers, we develop and design programs to identify audiences, create awareness and understanding, reach, connect and achieve our planned results. We do it daily for our clients in pharma and biotech, payers and providers. We have the weapons, and we can choose how to deploy them. The weapons are powerful — we know how to size and find audiences, and how to use digital technology to identify and reach them.
Engagement is a stated goal of nearly every campaign we launch, so we know how to connect. Community-level marketing is critical. And, of course, we know instantly what’s working and what’s not so that we can adapt and optimize.
All we need to do is harness this power to meet a different kind of objective. If we use our powers for good, and make diversity in clinical studies an accountable objective, we humble marketers can make a real difference. A difference for science, a difference for data, and, most importantly, a difference for humans.