Systematic reviews reveal unrepresentative evidence for the development of drug formularies for poor and nonwhite populations

Ref ID 400
First Author D. H. Odierna
Journal JOURNAL OF CLINICAL EPIDEMIOLOGY
Year Of Publishing 2009
URL https://www.jclinepi.com/article/S0895-4356(09)00030-4/fulltext
Keywords • Equity
• Pharmacological
Problem(s) • Failure to consider equity, different socioeconomic groups or disadvantaged populations
Article Type Empirical
Article Subtype Cross-sectional survey/Methodological systematic review
First Author Country United States
Aim To assess racial/ethnic, gender, and socioeconomic status concordance between Medicaid populations and studies synthesized in Drug Effectiveness Review Project systematic reviews.
Level of Investigation Descriptive
Summary of Findings Among Medicaid recipients, minorities are overrepresented (21% to 57%) compared with their presence in the US population (10% to 30%). 59% of included Drug Effectiveness Review Project systematic reviews reported insufficient evidence to evaluate drug effects by race/ethnicity or gender. 3% of reviews found evidence of differential effects by race and 13% by gender. 24% found evidence of no difference by race and 9% found no difference by gender. Most of this evidence was described as weak, limited, or of poor quality. Most DERP reviews reported insufficient evidence for any analysis of differential effects in subgroups defined by gender or race/ethnicity. Evidence should be collected and analysed in ways that allow policymakers to develop policies that support health equity in disadvantaged populations. Low-SES individuals should be an included subgroup in systematic reviews.
Number of systematic reviews included 32
Number of eligible systematic reviews assessed 32
Treatment impacted No
Treatment impacted description
Interpretation impacted Not Applicable
Interpretation impacted description