Addressing health disparities helps to expand access to solutions and improve health outcomes for people in underserved communities. It also allows us to gain unique perspectives and understanding that help us better meet the needs of patients. At Amgen, our health equity efforts are focused on expanding access to clinical trial participation among historically underserved populations, facilitating comprehensive health education, and engaging with community support systems.
Amgen Health Equity Framework and Strategy1
Amgen focuses its health equity efforts across three areas representing key elements of our health ecosystem: Representative Product Development, Comprehensive Health Education and Accessible and Inclusive Healthcare.
Advance policies and practices in support of achieving health equity with the goal that all people have an opportunity to be as healthy as possible
Our Focus Areas
Representative Product Development
Comprehensive Health Education
Accessible and Inclusive Healthcare
Work to address access to and participation in clinical trials and develop medicines to address unmet needs among historically underserved patients
Improve health literacy and education among historically underserved patients
Strengthen community and care support systems and access to medicines for historically underserved patients
Our Ambition Statements
Reduce disparities in early access to biomarker and diagnostic test utilization for lung cancer in Black Americans in Georgia over the next 3-5 years.
Increase support for and utilization of high quality, culturally competent patient care navigation services for cardiovascular disease in Black Americans in Florida over the next 3-5 years.
Improve quality of care by mitigating care continuum disparities for severe asthma in Hispanics in New York over the next 3-5 years.
Representative Product Development
The underrepresentation of racial and ethnic minority patients in clinical trials can contribute to the collection of incomplete or limited trial data, limited access to innovative treatment for vulnerable populations, and disparities in health outcomes. Barriers to participation include mistrust, lack of awareness, logistical challenges such as transportation, and provider bias.
We are working to reverse these challenges by addressing some of the root causes that deter people from participating in research. More representative patient populations in clinical trials are expected to help enable more accurate diagnoses, expand access to therapies and optimize treatment outcomes for patients, irrespective of a specific therapy or clinical trial.
We have developed an enterprise-wide framework to strengthen our focus on enhancing diversity and representation in clinical trial participation across our portfolio. We reflect the principles of this framework in our Global Code of Ethics for Clinical Trials. We have developed diversity plans for multiple clinical studies that align with both industry principles and U.S. Food and Drug Administration (FDA) guidance for industry to enhance diversity in clinical trials and encourage inclusivity in medical product development. We are also locating trials closer to historically underserved populations and incorporating remote visits to reduce the burden on participants.
In addition, through Amgen's Representation in Clinical Research team (RISE) we are engaging with representatives of historically underserved communities to obtain insights and perspectives on how best to address barriers that limit the diversity and representation of trial participants and investigators. Visit here to learn more about our commitment to representation in clinical research.
Comprehensive Health Education
Historically underrepresented populations have lower rates of diagnosis and screening for many life-threatening conditions – from cancer and heart disease to asthma.2 Delays in diagnosis, in some cases, mean patients don't receive access to potentially life-saving treatments until it is too late, leading to higher mortality rates for historically underserved communities.
We are focused on helping to equip patients with information they need to access healthcare services, manage chronic conditions more effectively and make informed choices about their health. By increasing patient, caregiver and provider access to culturally relevant health education, we can champion health within historically underserved communities.
Accessible and Inclusive Healthcare
We are working with partners to strengthen community and care support systems and access to medicines for historically underserved patients. This includes meeting patients where they are, helping them navigate the systems that deliver care, and addressing social determinants of health that may be contributing to disparities in healthcare.
Health Equity Ambition Statements
The three disease states identified as ambitions are among Amgen's top research and development priorities that also affect historically underserved communities.
Ambition 1: Reduce disparities in early access to biomarker and diagnostic test utilization for lung cancer in Black Americans in Georgia over the next 3-5 years.
Black Americans experience higher lung cancer morbidity and mortality compared with other racial and ethnic groups.3,8 In metastatic non-small cell lung cancer (NSCLC), eligible Black patients are about 12-15% less likely to receive biomarker testing compared to White patients, despite having the same percentage of driver mutations.5 And we see a higher prevalence of lung cancer among the Black population in the southern states, with Georgia being about 20% higher than states like New York, Nevada and New Mexico.6
Amgen aims to reduce biomarker and diagnostic test disparities for Black Americans in Georgia through key partnerships on the ground, such as with HEAL Collaborative (Health Education Advocacy and Learning), a community-based organization that partners with local faith groups and political leaders to provide awareness and education on lung cancer, clinical trials and biomarker testing.
Ambition 2: Increase support for and utilization of high quality, culturally competent patient care navigation services for cardiovascular disease in Black Americans in Florida over the next 3-5 years.
Nearly half of all African American adults have some form of heart disease3 and, like cancer rates, we see that according to CDC data in 2015, the highest rates of cardiovascular disease mortality for blacks were concentrated primarily in the Northeastern, Midwestern, and Southern United states—with Florida among many of those states reporting diverging trends in cardiovascular disease mortality between Whites and Blacks.4,7 Mistrust in the healthcare system due to historical medical discrimination and low treatment adherence rates are also common among the Black community. Similarly, clinician bias—conscious or unconscious—continues to impact healthcare delivery for Black and other historically underserved populations.8
Amgen's goal is to reduce cardiovascular disease disparities in the Black community in Florida by leveraging navigation services and trusted community resources that can educate, guide and support patients in their cardiovascular health. For example, Amgen is providing multi-year support for the American Heart Association's EmPOWERED to Serve Health Lessons program that partners with local community-based organizations to provide a curriculum of science-based modules to engage communities and motivate people to create an enduring culture of health.
Ambition 3: Improve quality of care by mitigating care continuum disparities for severe asthma in Hispanic Americans in New York over the next 3-5 years.
Visits to the emergency department for asthma in the Hispanic population are twice as frequent as non-Hispanic Whites.9 Data also suggest that the Puerto Rican population in the continental United States has the highest current asthma rate of any racial or ethnic group,10 and that Bronx and Kings counties in New York have the highest Puerto Rican populations in the U.S. according to Pew.11,12
A recent example of our work in this area includes the support Amgen is providing to the National Hispanic Medical Association's (NHMA) Asthma and Hispanics Education Campaign that seeks to increase awareness among key federal and state policymakers, patient advocates, and healthcare providers by specifically focusing on cultural competence and the barriers to achieving asthma control in the Hispanic communities in the United States.
Similarly, Amgen is supporting a multi-year program with The Asthma and Allergy Foundation of America's (AAFA) called the Health Equity Advancement and Leadership (HEAL) Innovation project. During each year of the project, HEAL Innovation will support four local, community-based asthma programs tailored to at-risk populations most impacted by asthma. The goal is to build and support community-based interventions to address inequities in asthma, specifically focusing on adults and adolescents, racial/ethnic minority populations, and socioeconomically disadvantaged populations.
- The three disease states identified as ambitions are among Amgen's top research and development priorities that also affect historically underserved communities.
- The AACR Cancer Progress Report and AACR Cancer Disparities Progress Report 2020
- The Heart Foundation. Sept 7, 2018. African Americans and Heart Disease. https://www.theheartfoundation.org/2018/09/07/african-americans-and-heart-disease/
- Van Dyke M, Greer S, Odom E, et al. Heart Disease Death Rates Among Blacks and Whites Aged ≥35 Years — United States, 1968–2015. MMWR Surveill Summ 2018;67(No. SS-5):1–11. DOI: http://dx.doi.org/10.15585/mmwr.ss6705a1
- Goodman, A.; More Widespread Biomarker Testing for NSCLC in Oncology Practices and More Testing in Black Patients: An Urgent Priority; The ASCO Post; August 25, 2021
- Lynch, J.A., Berse, B., Rabb, M. et al. Underutilization and disparities in access to EGFR testing among Medicare patients with lung cancer from 2010 – 2013. BMC Cancer 18, 306 (2018). https://doi.org/10.1186/s12885-018-4190-3
- Global Burden of Cardiovascular Diseases Collaboration. The Burden of Cardiovascular Diseases Among US States, 1990-2016. JAMA Cardiol. 2018;3(5):375–389. doi:10.1001/jamacardio.2018.0385
- Traylor, A.H., Schmittdiel, J.A., Uratsu, C.S. et al. Adherence to Cardiovascular Disease Medications: Does Patient-Provider Race/Ethnicity and Language Concordance Matter?. J GEN INTERN MED 25, 1172–1177 (2010). https://doi.org/10.1007/s11606-010-1424-8
- U.S. Department of Health and Human Services Office of Minority Health. Asthma and Hispanic Americans. https://minorityhealth.hhs.gov/omh/browse.aspx?lvl=4&lvlid=60
- American Lung Association. July 6, 2020. Current Asthma Demographics. https://www.lung.org/research/trends-in-lung-disease/asthma-trends-brief/current-demographics
- Pew Research Center. Puerto Rican Population Declines on Island, Grows on U.S. Mainland. D. Cohn, E. Patten, M. Lopez. August 11, 2014. https://www.pewresearch.org/hispanic/2014/08/11/puerto-rican-population-declines-on-island-grows-on-u-s-mainland/
- Pew Research Center. Puerto Rican Population by County. August 2019. https://www.pewresearch.org/hispanic/interactives/puerto-rican-population-by-county/