C. Breakout Sessions

2. Racial and Ethnic Differences in Response to Medicines

Michael A. LeNoir, MD, Director, Bay Area Multicultural Clinical Research Center
Richard Allen Williams, MD, President and CEO, Minority Health Institute, and Chief of Cardiology, West Los Angeles VA Hospital

Dr. LeNoir framed his presentation on health disparities as a "quality of care" issue. As such, understanding whether and how pharmaceutical safety and effectiveness varies across race and ethnicity is a critical element in addressing health disparities. Dr. LeNoir reported that the 20 most frequently prescribed drugs have not been tested for differences in safety and effectiveness across racial and ethnic groups. He also noted that there is insufficient gender diversity in clinical trials, as well. He identified two important underlying causes for this lack of information:

The recruitment and selection process for clinical trials fails to generate sufficient numbers of ethnically diverse subjects to test for statistically significant differences in reactions to medications across racial and ethnic groups.
Almost all the resources for research related to health disparities are targeted to academic medical centers, with little funding provided to practicing community physicians who are addressing disparities "in the trenches."

Dr. LeNoir recommended that:

The pharmaceutical industry should conduct studies to better understand racial and ethnic differences in responses to medications and open a dialogue with ethnic communities to address this issue.

The pharmaceutical industry, ethnic physicians and other health professionals should work together to increase the numbers of ethnic patients who seek to enter drug trials, the number who are accepted and, relatedly, the frequency of analyses of data from trials by race and ethnicity.

Dr. Williams presented the history of research regarding ethnic and racial differences in response to medicine. As early as the 1950s, researchers had noted that various ethnic groups had different levels of resistance to certain drugs when compared to white populations. Fortunately, work in this area has increased in recent years and will be greatly aided by the Human Genome Project. While some researchers question the ultimate usefulness of research in this area with the increased intermixing of races and ethnicities, Dr. Williams documented ethnic and racial differences in response to medicines in many areas. He also believes the pharmaceutical industry must become more committed to multicultural issues, including clinical trials.