New Studies Highlight the Public Health Risks of Inequities In Health Care Coverage

Pharmaceutical companies regularly distribute free drug samples to doctors, claiming that they benefit low-income patients who might not be able to afford the medicines. But new research from the Harvard Medical School and the Cambridge Medical Alliance claims that those giveaways usually end up in the hands of wealthy patients with health insurance. The Chronicle of Higher Education (subscription) reports on the results of the study, which will appear in the February issue of the American Journal of Public Health.

Pharmaceutical companies justify massive marketing budgets, which drive up drug costs, by citing large numbers of drug handouts. They claim that these free samples often go to the uninsured, who might not otherwise be able to afford these drugs. But according to the Chronicle, “More than four-fifths of the people receiving the freebies were covered by insurance all year…The groups that received a disproportionately high number of freebies were patients who were white… and had better access to medical care.” In addition to the disparity of access, there is also an increased likelihood that doctors will prescribe a drug that might not be right for the patient just because it is free.

The study demonstrates that pharmaceutical company marketing tactics that seem beneficent do not adequately compensate for a fundamentally flawed healthcare system that does not mandate a minimum level of care for all citizens regardless of income. Nevertheless, the Pharmaceutical Research and Manufacturers of America, a trade group, issued a statement saying that the studies, which use data from 2003, were “fatally flawed” since they do not take into account the outreach program that that the industry began in 2005. The statement goes on to point out that even though doctors are likely to consider patient income when giving free samples during an office visit, the uninsured often cannot make office visits in the first place.

But this is not the only recent news underscoring the threat an inequitable care system poses to public health. In an editorial published today, The New York Times argues for universal coverage and cites another study by Harvard Medical School finding that “uninsured near-elderly people got sicker at a faster rate than comparable people with insurance. Those disparities were sharply reduced when people turned 65 and became eligible for Medicare.” The NYT also pointed to a study from the American Cancer Society indicating that uninsured patients were less likely to receive cancer screenings, which means that cancers can go undetected until they progress and become more difficult to cure.

The inequities of the health industry present public health risks to an unacceptable number of Americans, and these recent studies provide more hard evidence of this unsustainable situation.

Image source: AP.

Tags: drug companies, healthcare, medicine

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