Issue Area - Individualized Care
Cultural and Genetic Diversity in America: The Need for Individualized Pharmaceutical Treatment, by Valentine J. Burroughs, et al., 2002
Pharmacogenetic research in the past few decades has uncovered significant differences among population groups in the metabolism, clinical effectiveness, and side effect profiles of many clinically important drugs. In addition, differences in how various populations view and respond to medicines underscores the need for an individualized approach to pharmaceutical therapy. Cost management policy design must take these differences into
account in order to ensure that they are broad and flexible enough to enable rational choices and individualized treatment for all patients, regardless of racial or ethnic origin. Fact Sheet available.
Annotated PowerPoint slides related to this report are available.
Ethnic Disparities in the Burden and Treatment of Asthma, 2005
In the United States the burden of asthma falls disproportionately on the black and Hispanic—largely Puerto Rican—populations, especially children. Much of this disparity has been attributed to unequal access to preventive care. Black and Puerto Rican children characteristically under-use routine health care services and overuse emergency care services for asthma. This report, developed in partnership with the Asthma and Allergy Foundation of America, discusses: disparities in the burden of asthma; possible hereditary, environmental, and behavioral causes of these disparities; and ways in which these asthma disparities may be lessened.
Annotated PowerPoint slides related to this report are available.
Genes, Culture, and Medicines: Bridging Gaps in Treatment for Hispanic Americans, by Carolina Reyes, MD, et al., 2004
This report brings together for the first time a growing body of scientific research demonstrating substantial disparities in pharmaceutical therapy for Hispanic Americans. These disparities in pharmaceutical treatment are substantial and often persist even after adjustment for differences in income, age, insurance coverage, and coexisting medical conditions. Emerging research demonstrates that genetic variations affect Hispanic Americans and may require dosage adjustments to achieve an optimal therapeutic effect.
Fact Sheet available.
Annotated PowerPoint slides related to this report are available.
Genetic Variations in Response to Medications: Looking at the Implications for Minority Elders, by Richard Levy and Jean Polatsek, Healthcare and Aging, Vol. 9, No. 1, Spring 2002
Genetic, environmental and cultural factors influence variations in drug response among elders from different racial and ethnic backgrounds. Racial and ethnic heritage can be an indicator of special medical needs and differing drug responses; if ignored these differences in treatment response, can lead to compromised care and greater health risks. In addition, substantial dosing
adjustments may be necessary to avoid overdosing or underdosing. Reprinted with permission from Healthcare and Aging, Vol. 9, No. 1, Spring 2002. Copyright © 2002 American Society on Aging San Francisco, California. Also published in Diversity Currents, Vol. 4, No. 2, Spring 2002.)
The Importance of Individualized Pharmaceutical Therapy in the Treatment of Diabetes Mellitus, by David B. Nash, MD, MBA, et al., Disease Management, Vol. 4, Suppl. 1, 2001
Individualized pharmaceutical care for patients with diabetes is necessary due to the variety among the patient population, the frequency and severity of concurrent medical conditions, and other factors that influence individual health and treatment options. This 22-page supplement to the journal Disease Management emphasizes how proper care tailored to individual patient needs can improve overall health and reduce more serious complications. Fact sheet available.
The Importance of Individualizing Prescribing among Genetically and Culturally Diverse Groups, by Valentine J. Burroughs, MD, Group Practice Journal, Vol. 52, No. 3, March 2003
Addressing individual patient needs can provide better overall utilization of health care resources and improve health outcomes. Because patients differ in how their bodies process drugs due to many factors—age, gender, genetic variations, etc.— patients may experience different levels of effectiveness from drug therapies and variations in side effects associated with a particular drug. Thus individualized prescribing is key to making sure that each patient receives the right drug, in the right dose, and at the right time.
Individualized Prescribing for the Elderly, by Karen D. Novielli, MD, et al.,
Pharmacy & Therapeutics, September 2001 (Supplement)
Advances in health care and pharmaceuticals have made it possible to treat many diseases that manifest as people age. However, a "one-drug-fits-all" approach is not ideal, especially for older patients, who are exposed to unique health-related variables. When these variables interact in an older patient, individualized drug therapy is required. Note: The CE credit option on this piece has expired.
Pharmaceutical Diversity Serves Human Diversity: Medications for Older Adults, by Richard A. Levy, PhD, Healthcare and Aging, Vol. 7, No. 4, Winter 2000
Genetic differences in response to medicines are now known to involve some of the medications most used among elders, including drugs for high blood pressure, depression and life-threatening infections. New scientific findings about genetic influences on the effects of medications call for increased focus on subgroups of patients and on individuals. (Reprinted with permission from
Healthcare and Aging, Vol. 7, No. 4, Winter 2000. Copyright © 2000 American Society on Aging, San Francisco, California.)
Pharmaceuticals for Elders: Why Innovation Matters, by Albert Wertheimer, Healthcare and Aging, Vol. 9, No. 1 Spring 2002
The current policy debate over drug-benefit reform and improved access to needed medicines for elders has generated considerable confusion and many
misperceptions regarding the nature and value of incremental pharmaceutical innovation. Cumulatively, these new medicines allow for precision treatment of the individual needs of diverse patients, which is especially important for
optimal treatment of older patients, because age-related physiological changes and individual differences may produce markedly diverse responses to medications in older adults. (Reprinted with permission from Healthcare and Aging, Vol. 9, No. 1, Spring 2002. Copyright © 2002 American
Society on Aging San Francisco, California.)
Racial and Ethnic Differences in Response to Medicines: Towards Individualized Pharmaceutical Treatment, by Valentine J. Burroughs, Randall W. Maxey, and Richard A. Levy, Journal of the National Medical Association, Vol. 94, No. 10 (Suppl.), October 2002
It is now well documented that substantial disparities exist in the quality and
quantity of medical care received by minority Americans, especially those of African, Asian, and Hispanic heritage. In addition, the special needs and responses to pharmaceutical treatment of these groups have been undervalued or ignored. This article reviews the genetic factors that underlie varying responses to medicines observed among different ethnic and racial groups.
Annotated PowerPoint slides related to this report are available.
CME credit is available through the National Medical Association.
Executive Summary: Too Many Drugs? The Clinical and Economic Value of Incremental Innovations, by Albert Wertheimer, Richard Levy and Thomas O'Connor, 2001
Some believe that incremental advances within the pharmaceutical industry are too costly and do not ultimately benefit the consumer. This is a misconception. The new agents resulting from this evolutionary process can offer advantages in terms of improved efficacy, better patient satisfaction and compliance and, in some cases, greater cost effectiveness.
Annotated PowerPoint slides related to this report are available.
Too Many Drugs? The Clinical and Economic Value of Incremental Innovations, by Albert Wertheimer, Richard Levy and Thomas O'Connor, Research in Human Capital and Development: Investing in Health: The Social and Economic Benefits of Health Care Innovation,
Vol. 14, 2001
The history of clinical pharmacology is characterized by incremental improvements in the safety, efficacy, selectivity, and utility of drugs within a given class. This report makes the case for a fully developed class of drugs to allow precision prescribing in order to achieve optimum outcomes in the most cost effective manner.
Annotated PowerPoint slides related to this article are available.
Toward Individualized Pharmaceutical Care of East Asians, by Alan Morrison, PhD, and Richard A. Levy, PhD, Pharmacogenomics, Vol. 5,
No. 6, September 2004
Research into the relationship between genetics and drug response has focused on variations in genes that encode drug-metabolizing enzymes. Much of this work has targeted East Asians, a genetically distinguishable and populous group. Variations known to inactivate a drug-metabolizing enzyme are predictive of poor metabolism of drugs processed by that pathway. Genetic tests can be used to screen for individuals who are poor metabolizers, with the ultimate goal of better predicting the clinical effects of drugs. A non-technical summary of this paper is available.
The Value of Incremental Pharmaceutical Innovation for Older Americans, by Albert Wertheimer, PhD, MBA, Thomas W. O'Conner, Jr., PharmD, MBA, and Richard Levy, PhD, 2001
This monograph explains that small incremental improvements within drug classes provide important health benefits, especially for elderly patients. The monograph illustrates therapeutic advantages of these newer drugs in a class including: fewer side effects, improved safety and greater effectiveness; easier use, which facilitates compliance with prescribed regimens; and better tailoring to fit individual patient needs. Fact sheet available.
Why the Elderly Need Individualized Pharmaceutical Care, by David Nash, MD, MBA, et al., April 2000
A “one drug fits all” approach does not work for elderly patients because they are exposed to unique health variables that are rare in younger patients. This 18-page report explains the pharmacological, physiological and epidemiological reasons why therapy for this population must be personalized.
Annotated PowerPoint slides related to this report are available.
Fact sheet available.
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