There are significant opportunities to improve the health of all people through understanding and addressing health disparities in our communities, particularly in key therapeutic areas such as oncology, cardiovascular and inflammation.

The Amgen Health Equity Framework and Strategy

At Amgen, we believe health is equitable when everyone, everywhere can be as healthy as possible regardless of where you come from, what you look like, or what language you speak. To help achieve this, we are working to ensure that all people have access to available treatment options, diagnostics and the ability to participate in clinical trials.  To achieve our vision, 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.
 

Our Vision

Advance policies and practices in support of achieving health equity so 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

Our Objectives

Expand 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

Ambition One: Reducing Biomarker and Diagnostic Disparities: Lung Cancer in Black Americans in Georgia over the next 3-5 years

Ambition Two: Increasing Care Navigation: Cardiovascular Disease in Black Americans in Florida over the next 3-5 years

Ambition Three: Improving Health Care Quality: 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 contributes 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. Amgen believes that when we improve the health of those who have been underrepresented and historically underserved for far too long, we improve the health of everyone.

Amgen is working to improve the proportional representation of trial participants in clinical trials, by addressing key systemic issues that deter people from participating in research, especially those groups who have been historically underserved due to race, ethnicity, sex, age, and other factors.

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 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 and underrepresented populations and incorporating remote visits to reduce the burden on participants.

In addition, through Amgen's Representation in Clinical Research team, known as RISE, we are engaging with representatives of historically underserved and underrepresented 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. 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 underrepresented and underserved populations.

Amgen is working to improve health literacy and education among historically underserved patients so that patients, their caregivers, their families, and their communities have a better understanding of health conditions, can be more engaged in discussions with healthcare providers, and empowered to make more informed choices about their health.

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.

Health Equity Ambition Statements

In addition to this framework, Amgen has created a set of aspirational yet targeted "Ambition Statements" to complement our strategy and inform a roadmap for actionable interventions and solutions that will help achieve our strategic vision. Our ambition statements are as follows:

  1. Diagnostics: Reduce disparities in early access to biomarker and diagnostic test utilization for lung cancer in Black Americans in Georgia. 
  2. Care Navigation:  Increase support for and utilization of high quality, culturally competent patient care navigation services in cardiovascular disease for Black Americans in Florida.
  3. Standard of Care: Improve quality of care of Hispanic server asthma patients by mitigating care continuum disparities in New York. 

The three disease states identified are among Amgen's top research and development priorities that also impact historically underserved communities. By doing so, we can apply our deep expertise in these areas and activate our broad cross-sector networks to be more effective in developing solutions. 

Ambition 1: Reducing Biomarker & Diagnostic Test Disparities: Lung Cancer in Black Americans in Georgia

Black Americans experience higher lung cancer morbidity and mortality compared with other racial and ethnic groups. 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 mutations1. 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 Mexico2.

Amgen aims to reduce biomarker and diagnostic test disparities for Black Americans in Georgia through key partnerships on the ground, such as 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: Increasing Care Navigation: Cardiovascular Disease in Black Americans in Florida

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 CVD mortality for blacks were concentrated primarily in the northeastern, midwestern, and southern states—with Florida among many of those states reporting diverging trends in CVD mortality between Whites and Blacks.4,5 Mistrust in the healthcare system due to historical medical injustices and low treatment adherence rates are also common among the Black community. Similarly, clinician bias—unconscious or not—continues to impact healthcare delivery for Black and other historically minoritized populations.6

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: Improving Care Quality: Severe Asthma in Hispanics in New York

Visits to the emergency department for asthma in the Hispanic population are twice as frequent as non-Hispanic Whites.7 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,8 and that Bronx and Kings counties in New York have the highest Puerto Rican populations in the U.S. according to Pew.9,10

A recent example is support Amgen is providing to the National Hispanic Medical Association's (NHMA) to support their Asthma and Hispanics Education Campaign with the purpose of increasing awareness among key federal and state policymakers, patient advocates, and healthcare providers 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.


References:

  1. 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
  2. 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
  3.  The Heart Foundation. Sept 7, 2018. African Americans and Heart Disease. https://www.theheartfoundation.org/2018/09/07/african-americans-and-heart-disease/
  4. 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
  5. 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
  6. 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
  7. 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
  8. American Lung Association. July 6, 2020. Current Asthma Demographics. https://www.lung.org/research/trends-in-lung-disease/asthma-trends-brief/current-demographics
  9. 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/
  10. Pew Research Center. Puerto Rican Population by County. August 2019. https://www.pewresearch.org/hispanic/interactives/puerto-rican-population-by-county/