Clinical trials are the backbone of medical innovation from life-saving drugs to new technology. Despite clinical trials being crucial in medical creation, there are significant discrepancies in access to clinical trials. At the end of 2022, 437,538 clinical trials were published on clinicaltrials.gov (Clinical Trials, 2023). With a considerable amount of trials hosted each year, there are significant costs put onto the hospitals, but then also the patient. Typically, health insurance covers clinical trials. This is due to trials and research being a typical last resort to be able to treat a condition. What happens if a patient doesn’t have health insurance or their insurance doesn’t cover the treatment? The accessibility to different socioeconomic communities comes to light and is debated regarding whether there is a proper diverse representation within trials.
Diversity in trials is important; racial, gender, and socioeconomic. According to a recent study, 75% of the 32,000 participants in the trials of drugs approved by the 2020 FDA were white, demonstrating the inadequacy of racial diversity within research (Gray et al., 2021). Certain races and areas are more prone to certain cancers or respiratory diseases, a field called chronic disease epidemiology, yet these areas and races are not adequately represented in clinical trials. For example, 12.4% of pancreatic cancer diagnoses in the US identify as Black, yet only 8.2% of participants in pancreatic cancer clinical trials identify as Black (Altersitz, 2021). According to Dr. Robert Paris, Head of Translational Medicine, Infectious Diseases at Moderna, “Poor health care access and associated health outcomes may limit eligibility for studies.” Healthcare deserts and distrust in the medical care community can also impact the likelihood of gaining participants in this area. This is seen especially in low socioeconomic areas, creating a further divide.
Overall, there is a discrepancy and inequality present within the current clinical trial system. Primarily white Americans are represented in research findings despite certain conditions affecting people differently. This partially stems from where clinical trials are available, socioeconomic status impacting insurance, and what can be afforded, but also how these clinical trials find participants. To continue to truly advance medicine, additional work is needed to bridge the gap to ensure people of color and low socioeconomic communities have access to clinical trial resources, and also that all types of people are represented in the data to certify their ability to work for everyone.
Works Cited:
Gray et al.,Diversity in Clinical Trials: An Opportunity and Imperative For Community
Engagement,
Person, et al. “Pancreatic Cancer Trials Fall Short on Diversity.” Healio, 17 May 2021,
diversity.
“Trends, Charts, and Maps.” ClinicalTrials.Gov, clinicaltrials.gov/ct2/resources/trends. Accessed
31 July 2023.
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