Skip to main content

Advertisement

Log in

Personalized Therapeutics: A Potential Threat to Health Equity

  • Perspectives
  • Published:
Journal of General Internal Medicine Aims and scope Submit manuscript

ABSTRACT

Throughout history, medical advances have been adopted first and preferentially by the well educated and economically advantaged groups. The development of personalized therapeutics holds promise to fundamentally alter the practice of clinical medicine, but if it also is used preferentially by economically advantaged groups, this advance will likely worsen socioeconomic disparities in health. Prospective development of strategies to ensure non- differential access to these therapies may help limit this unintended consequence of medical progress for economically disadvantaged groups.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

REFERENCES

  1. Hudis CA. Trastuzumab – Mechanism of action and use in clinical practice. N Engl J Med. 2007;357:39–51.

    Article  PubMed  CAS  Google Scholar 

  2. Epstein RS, Moyer TP, Aubert RE, et al. Warfarin genotyping reduces hospitalization rates: Results from the MM-WES (Medco-Mayo Warfarin Effectiveness Study). J Am Coll Cardiol. 2010;55:2804–12.

    Article  PubMed  CAS  Google Scholar 

  3. Secretary’s Advisory Committee on Genetics, Health, and Society. Realizing the Potential of Pharmacogenomics: Opportunities and Challenges. Washington, DC: U.S. Department of Health and Human Services; 2008. http://oba.od.nih.gov/oba/sacghs/reports/SACGHS_PGx_report.pdf.

    Google Scholar 

  4. Phelan JC, Link BG, Diez-Roux A, Kawachi I, Levin B. “Fundamental causes” of social inequalities in mortality: a test of the theory. J Health Soc Behav. 2004;45:265–85.

    Article  PubMed  Google Scholar 

  5. Link B, Phelan J. Social conditions as fundamental causes of health disparities. In: Bird CE, Conrad P, Fremont AM, Timmermans S, eds. Handbook of Medical Sociology. 6th ed. Nashville, TN: Vanderbilt University Press; 2010:3–17.

    Google Scholar 

  6. Carmichael AG. Plague and the poor in Renaissance Florence. Cambridge: Cambridge University Press; 1986.

    Google Scholar 

  7. Ewbank DC, Preston SH. Personal health behavior and the decline in infant and child mortality: the United States, 1900 – 1930. In: Caldwell JC, Findley S, Caldwell P, Santow G, Cosford W, Braid J, Broers-Freeman D, eds. What we know about health transition: The cultural, social, and behavioural determinants of health. Canberra: Australia National University; 1990:116–49.

    Google Scholar 

  8. Stamler J. The marked decline in coronary heart disease mortality rates in the United States, 1968-1981; summary of findings and possible explanations. Cardiology. 1985;72:11–22.

    Article  PubMed  CAS  Google Scholar 

  9. McFarland W, Chen S, Hsu L, Schwarcz S, Katz M. Low socioeconomic status is associated with a higher rate of death in the era of highly active antiretroviral therapy, San Francisco. J Acquir Immune Defic Syndr. 2003;33:96–103.

    Article  PubMed  Google Scholar 

  10. Smith GD, Neaton JD, Wentworth D, Stamler R, Stamler J. Socioeconomic differentials in mortality risk among men screened for Multiple Risk Factor Intervention Trial: I. White men. Am J Public Health. 1996;86:486–96.

    CAS  Google Scholar 

  11. Ward MM. Socioeconomic status and the incidence of ESRD. Am J Kidney Dis. 2008;51:563–72.

    Article  PubMed  Google Scholar 

  12. Liao Y, Tucker P, Okoro CA, Giles WH, Mokdad AH, Harris VB. REACH 2010 Surveillance for health status in minority communities – United States, 2001-2002. MMWR Surveill Summ 2004;

  13. Khoury MJ, Feero WG, Reyes M, et al. The Genomic Applications in Practice and Prevention Network. Genet Med. 2009;11:488–94.

    Article  PubMed  Google Scholar 

  14. Florentinus SR, van Hulten R, Kloth ME, et al. The effect of pharmacotherapy audit meetings on early new drug prescribing by general practitioners. Ann Pharmacother. 2007;41:319–24.

    Article  PubMed  Google Scholar 

  15. Choudhry N, Lee JL, Agnew-Blais J, Corcoran C, Shrank WH. Drug company-sponsored patient assistance programs: a viable safety net? Health Aff. 2009;28:827–34.

    Article  Google Scholar 

  16. Weinberg M. Reforming patient assistance programs: perfect world meets real world. Health Aff. 2009;28:839–42.

    Article  Google Scholar 

  17. Sambamoorthi U, Olfson M, Walkup JT, Crystal S. Diffusion of new generation antidepressant treatment among elderly diagnosed with depression. Med Care. 2003;41:180–94.

    Article  PubMed  Google Scholar 

  18. Haider SI, Johnell K. Ringbäck Weitoft G, Thorslund M, Fastbom J. Patient education level and use of newly marketed drugs: a register-based study of over 600,000 older people. Eur J Clin Pharmacol. 2008;64:1215–22.

    Article  PubMed  Google Scholar 

  19. Wells KJ, Battaglia TA, Dudley DJ, et al. Patient navigation: state of the art or is it a science? Cancer. 2008;113:1999–2010.

    Article  PubMed  Google Scholar 

  20. Bradford JB, Coleman S, Cunningham W. HIV system navigation: an emerging model to improve HIV care access. AIDS Patient Care STDS. 2007;21(Suppl 1):S49–58.

    PubMed  Google Scholar 

  21. Strathdee SA, Palepu A, Cornelisse PG, et al. Barriers to use of free antiretroviral therapy in injection drug users. JAMA. 1998;280:547–9.

    Article  PubMed  CAS  Google Scholar 

  22. Godwin NC, Willig JH, Nevin CR, et al. Underutilization of the AIDS Drug Assistance Program: associated factors and policy implications. Health Serv Res. 2011;46:982–95.

    Article  PubMed  Google Scholar 

Download references

ACKNOWLEDGMENTS

This work was supported by the Intramural Research Program, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health.

The views expressed in this article are those of the author, and do not represent those of the National Institutes of Health or the U.S. Department of Health and Human Services.

Conflict of Interest

The author declares there is no conflict of interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Michael M. Ward MD, MPH.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ward, M.M. Personalized Therapeutics: A Potential Threat to Health Equity. J GEN INTERN MED 27, 868–870 (2012). https://doi.org/10.1007/s11606-012-2002-z

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11606-012-2002-z

Keywords

Navigation