Last October, we published a post explaining social determinants of health. Since then, COVID-19 has changed the discussion, and we felt the topic was worth revisiting, taking COVID-19 into account.
Social determinants of health (SDoH) are conditions in the places where people live, learn, work, and play that affect a wide range of health and quality-of life-risks and outcomes.1 The COVID-19 pandemic as well as the transition from volume‐based to value‐based care has motivated both providers and payers to address social risk factors to improve clinical and financial outcomes. You’ve probably seen or read the term in headlines, presented at conferences, or discussed at roundtables and meetings, but rarely mentioned in the coverage of SDoH is the pivotal role that pharma can play. Many leading pharmaceutical manufacturers have launched initiatives and partnerships aimed at addressing the impact of SDOH on health outcomes.
Working to advance health equity is not new for pharmaceutical manufacturers like Merck, who recently hired an executive director of social determinants and population health, Conrod Kelly. He explains that Merck is “using social determinants as a framework to assess commercial decisions, improve diversity of their clinical trials, shape their policy efforts, and guide their strategic partnerships, all in support of the company’s commitment to advancing health equity.”2
Determinants, or drivers of health, are not a novel concept, yet there has been explosion of interest across the healthcare value chain, especially in the midst of the current COVID-19 pandemic. The pandemic exposed stark disparities and highlighted how minority communities are at greater risk from COVID‐19. For example, many African American communities are more vulnerable due to underlying health conditions, employment as “essential” workers, limited access to healthcare services and insurance, and greater reliance on public transportation. COVID‐19 presents a unique opportunity for researchers to better understand the vulnerabilities of disparate communities and provide a contextualized approach to treatment. If researchers can use SDOH to better understand why African Americans are disproportionately impacted by COVID‐19, pharmaceutical companies will to be able to develop more customized treatments and assist in improving outcomes. 3
COVID‐19 has disproportionately impacted vulnerable individuals, families, and communities. SDOH provide a common language that stakeholders can use to reach out to their legislatures to address areas that need change. It is imperative that policymakers, researchers, and community leaders develop policies that support the use of SDOH in a meaningful way.
Rarely does a patient not want to be healthy. They need support to overcome obstacles keeping them from being healthy such as medication adherence.4 Patients don’t wake up in the morning and think “I’m not going to follow what my doctor told me to do today.” Studies show that there are correlations to how patients live their lives and how effective drugs are. Coupling this with arguably one of the most important determinants, health literacy, pharma has an incentive and an opportunity to address SDoH in a variety of ways.
- More accurate and effective patient identification (for treatment)
- SDoH data can be used to identify if there are key barriers that prevent patients from considering or starting treatment (like health literacy)
- Supporting HCPs in identifying the right treatment / treatment plan for patients
- Use SDoH data to help HCPs determine the right treatment for the right patients for this product (e.g., it may be better for a patient with limited transportation to be offered a treatment option that does not require many in office visits)
- Develop more relevant patient support solutions and services
- Utilize SDoH data to identify the patients facing limitations (lack of transportation, debt, no insurance, more concerned about basic needs, etc.) and to address those limitations. This ensures greater patient adherence and supports better disease management
Since SDoH data has only recently become more accessible, we are only scratching the surface in terms of what the healthcare industry can learn from this data, and as a result, what potential new services and solutions can be created to drive better health outcomes. Only by learning about the true needs and social risks of the patients they are serving will pharma be able to deliver better outcomes; and there is no better time to start than now.
1https://www.who.int/social_determinants/sdh_definition/en/