Many prescription drugs come with labels that suggest different dosing based on race or ethnicity. These labels can hint that some groups might need lower doses or might experience more side effects. Medical guidelines often support the idea of varying prescriptions according to a patient’s race or ethnicity.
These race-based recommendations show up in medications for heart disease, cancer treatments, epilepsy, tuberculosis, and more. Unfortunately, biases in healthcare can lead to unequal prescribing practices, especially for pain management and substance use disorders.
When journalists tell these stories, they should highlight how genetic ancestry affects drug responses while clarifying that race and ethnicity are social constructs. Understanding this distinction is crucial.
Medications are not one-size-fits-all. Genetic differences can influence how effective a drug is or what side effects a patient might face. Just because a study is conducted on a specific racial group doesn’t mean those genetic traits are unique to that group. This can worsen health disparities when prescribing practices rely heavily on racial labels.
As Jasmine Luzum, a researcher at the University of Michigan, points out, “There’s more genetic variability within a race group than between race groups.” This makes it problematic to base drug recommendations on race.
Race-based guidelines are typically found in the “Warnings,” “Dosage,” or “Use in Specific Populations” sections of drug labels and in clinical practice recommendations. They can also appear in computer algorithms that help doctors decide on dosages.
Data often over-represent people of European descent, leaving gaps in our understanding of genetic variants in other populations. This can make race seem more relevant than it truly is. For instance, a study compared race-based dosing for the blood thinner warfarin and found that it may not account for all genetic factors. More inclusive studies are needed to address these disparities adequately.
It’s also worth noting that the FDA sometimes recommends genetic testing before prescribing certain medications, but only for specific racial or ethnic groups. This risks missing patients from broader backgrounds who might also face similar risks. For example, genetic screening for the epilepsy drug carbamazepine is suggested only for those of Asian descent. However, broader testing could catch more individuals at risk for severe reactions.
Journalists can explore why genetic testing isn’t more widely applied and how insurance policies impact these recommendations. It’s essential to understand the systems that might reinforce racial biases in prescriptions.
Disparities in pain management are well-documented. Studies show that white patients often receive opioids more readily than Black patients. This bias extends to other medical conditions, including endometriosis, where diagnosis and treatment may vary significantly based on race.
Investigating these disparities can help shed light on how implicit biases affect treatment choices. Reporters should delve into current guidelines on chronic pain management and examine steps taken by local clinics to combat bias.
Recommendations based on race can hurt everyone involved. Caution against using certain first-line treatments for specific populations can deny them access to effective drugs. Simultaneously, limiting genetic tests to select groups can leave other patients vulnerable. For example, guidelines that discourage using certain hypertension treatments in Black Americans are concerning, as high blood pressure is more prevalent in these populations.
Highlighting who is included or excluded from medical guidelines can uncover important stories about health equity and the need for fair treatment across all patient groups.
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disparities,prescription,race,race-based algorithms
