Health Equity: IHI and Genentech on the Need for an Industry-Wide Approach

Over the last several years, we have experienced a true sea change in the way equity is discussed and prioritized across the health care system. Many have come to an important moment of understanding that the care provided to, and the outcomes experienced by, patients are deeply inequitable. We desperately need a course correction to bring positive change to our health care ecosystem.

As a result of these inequities, and a desire to accelerate the difficult work of creating a more just health care system, partners from across health and health care have come together to form the Rise to Health Coalition, a nationwide initiative to achieve health equity by bringing together individuals and organizations to transform health care through coordinated and collective action.

Two leaders supporting the Rise to Health Coalition—Institute for Healthcare Improvement (IHI) President and CEO Kedar Mate and Genentech’s Senior Vice President and Head of Public Affairs and Access Fritz Bittenbender—sat down to discuss these challenges and possible solutions.

On why an industry-wide approach to health equity is necessary

Kedar Mate: Through previous equity initiatives, IHI realized that while health systems could make care better for currently and historically underserved populations by working within their communities, delivery systems, hospitals, and health care systems they couldn’t sustain the work on their own. This required the partnership of the payers paying for care, the biotech and pharmaceutical companies creating the treatments they needed to deliver, and the professional societies creating the algorithms and treatment support protocols. These efforts demonstrated that achieving health equity required something broader than only those involved in care delivery. We needed a more holistic approach to tackling the challenge of health equity.

Fritz Bittenbender: In my conversations across the health care industry—whether it's with hospitals, health plans, or with policymakers—health equity remains front and center. One of the wonderful things about the Rise to Health Coalition is how it brings a wide array of people and organizations together to collectively solve a problem. It’s about how we can bring about much-needed change for our society. We cannot solve these problems in a silo, so we have to work together across various parts of the industry to achieve long-term solutions. The Rise to Health Coalition is playing that important convening role.

On the role of biotech in advancing health equity

Bittenbender: For biotech companies like Genentech, I see three critical areas of concern if we are serious about equity. First, clinical trials don’t always reflect the real-world demographics of the types of disease we’re working to target. We need to diversify our clinical trials so they better represent real-world incidences of disease around the country. Second, due to systemic barriers—including a lack of trust in our health care system or geographic isolation from research centers or clinical trials—not everyone is getting access to medical advances and innovations. Lastly, we have a real underdiagnosis problem in some key diseases, which leads to terrible inequities. In multiple sclerosis, for example, African American populations have a higher incidence of underdiagnosed disease. If you never get an accurate diagnosis, how can you get appropriate treatment?

Many across industry—including Genentech—are at a critical point in our efforts to address these longstanding inequities. As the world’s first biotechnology company, we believe it’s our responsibility to move beyond simply declaring health equity to be a priority to figuring out how to make it actionable. In addition to prioritizing diversity and inclusion in our own clinical research and expanding access to innovative treatments, we are prioritizing community-driven partnerships beyond the walls of Genentech. In Flint, Michigan, for example, we are working with the National Minority Quality Forum to advance equitable cancer care and improve cancer outcomes by working to combine the collective leadership of Flint community-based organizations, researchers, clinicians, and community leaders. These examples of collective action taking place on a local and national level are critical to building a future of health care that truly serves all.

On health equity as a moral–and business–imperative

Mate: One aspect that I’ve been thinking about is how advancing equity can lead to bottom line improvements for health care businesses. People often think of improving equity and increasing access as a moral imperative. But there are also major business advantages if we can achieve greater equity in health care.

Bittenbender: There is definitely a business imperative in making the health care industry more equitable. It is indeed the right thing to do, and we also think it will support growth in our industry and business in the future, which will in turn fuel continued innovation for patients. When we remove barriers for the patients and communities that have been marginalized by the health care system, everyone benefits. That’s the great thing about expanding access: it helps people get the treatment they desperately need while also reaching new patient populations that we can’t currently treat. We want to solve the equity problem fundamentally because it’s the right thing to do, but we cannot overlook that it is also a wise business move that hopefully leads to more innovation and broader impact. As we continue to learn and innovate, we can then reinvest those dollars in new approaches and solutions to advance health equity and improve health outcomes for all through our business capabilities.

This conversation has been edited for length and clarity.

The editorial staff had no role in this post's creation.