Understanding Pharmaceuticals and Health Disparities: An Alternative Approach

Despite the expansion of the global pharmaceutical market, the unprecedented increase in prescription utilization over the last decade, and the critical role of pharmaceuticals in the mitigating suffering and improving survival, social (e.g. gender, race/ethnicity and socioeconomic) disparities in health outcomes continue to be a persistent problem in the U.S., and globally. While the public health literature has extensive documentation of social disparities in health and health care, information on similar disparities in the use of pharmaceuticals (prescription and non-prescription) is limited. Disparities in the use of pharmaceuticals, particularly underuse in socially disadvantaged populations, may be an important, yet overlooked, contributor to health disparities. This information is particularly important for the development of pharmaceutical policies intended to improve access to medicines in these socially disadvantaged populations. The majority of existing data sources for which medication use measures are derived (claims or clinic-based data), however, often exclude data on the most socially disadvantaged populations. Thus, there is an incomplete understanding of the relationship between pharmaceutical use and social disparities in health. This paper will: 1)Discuss the limitations of current approach in measuring disparities in the use of pharmaceuticals in the U.S.; 2)Present a conceptual framework that illustrates the underlying factors associated with the use of medicines and disparities in their use from a societal perspective; and, 3)Discuss the advantages of population-based pharmaceutical data in advancing our understanding of social disparities and developing effective pharmaceutical policies that seek to promote health equity.