How health equity can drive commercial excellence

Embedding leading health equity principles across operations can help pharma companies address disparities and drive commercial success.

In brief

• Pharma leaders should consider the benefits of transforming their operations by advancing health equity. 
• Data analytics on health disparities and barriers to equitable care yield deep insights on the progression of disease and outcomes for specific patient groups.
• Embedding these insights into launch and commercialization plans provides a holistic view of a patient population that can unlock significant enterprise value.

Case study: a window into health equity in the context of chronic

kidney disease

Chronic kidney disease (CKD) supplies a useful lens into the barriers to health equity, and this perspective can enable companies to drive revenue and far-reaching societal value. From structural factors to unhealthy community conditions and predisposition to CKD, we know that there are disparities at every stage of the continuum of care for this life-threatening — and often chronic or lifelong — condition, particularly for Black Americans.[⁴]

Figure 1: Patients diagnosed with CKD, by race and disease stage (2016-21)

Source: EY analysis of Komodo claims database

For instance, Black people in the US are over three times more likely than their White peers to be diagnosed with end-stage renal disease,[⁵] which causes permanent cessation of kidney function and requires long-term dialysis or kidney transplant. Moreover, approximately 44% of excess risk for CKD among Black Americans is caused by modifiable risk factors around lifestyle, clinical conditions, structural drivers and more.[⁶] More broadly speaking, barriers to access also mean that underserved populations experience delayed entry into the health ecosystem to address chronic conditions like CKD. Despite this, in 2014 and 2015, Black CKD patients were nearly 25% less likely to receive pre-dialysis care than White patients with the condition (for Hispanic patients, that figure was a staggering 39%).[⁷] In addition, Black patients were nearly 80% more likely to die because of CKD than White patients.[⁸]

With progressive diseases like CKD, early intervention and ongoing monitoring are needed to drive better outcomes. But, as discussed above, several barriers to health equity impact how (and, in many cases, whether) patients from underserved racial and ethnic groups experience each stage of the disease journey. The costs around not closing this disparity gap are astronomical — by one estimate, more than $4 billion.[⁹] For pharma companies, these sobering realities also present a significant opportunity to engage with key stakeholders around affordability and access to drive enterprise value by enabling more successful patient outcomes.

Figure 2: Emergency department visits of CKD patients, by race 

Source: EY analysis of Komodo claims database

Figure 3: Average number of distinct kidney specialist visits of CKD patients (Stage 4, Stage 5 and end-stage renal disease, 2016-21)

Source: EY analysis of Komodo claims database

A value-centric approach to incorporating health equity into the

pharma commercialization model

For pharma companies and other stakeholders across the health ecosystem, the gaps discussed above represent a missed opportunity to improve both patient access and outcomes for underserved racial and ethnic groups. By contrast, deep insights on health equity in the context of a specific intervention or medicine have the potential to enable better, earlier care. This, in turn, not only enhances patient outcomes but also helps leading health and wellness organizations achieve their environmental, social and governance (ESG) ambitions in a specific and actionable manner.

Advancing health equity in the context of commercialization can supply significant value for the pharmaceutical industry through increased market share and improvements in top-line revenue. 

By prioritizing the five actions below, pharma leaders can begin to address long-standing health equity challenges and drive long-term value for both underserved groups and the organization.

Figure 4: EY framework for health equity as a value driver

Article includes contributions from Elias Wehbe, CEO, Big Little Robots and Bonnie Yang, EY Americas Care Delivery Transformation Senior Consultant, Ernst & Young, LLP.