AMCP Summit: Addressing Health Disparities

• Provided by ProCE, LLC 
• Supported by Bristol Myers Squibb. 
• Continuing education credit available for pharmacists, including managed care, specialty, and clinical pharmacists, who care for patients with cancer, as well as pharmacy directors, chief pharmacy officers, and other stakeholders in pharmacy practice. 
• Contact hours: 1 

The growing recognition of healthcare disparities is challenging healthcare professionals (HCPs), policy makers, and educators to examine how inequities affect clinical outcomes and the quality and delivery of cancer care. Significant barriers to cancer health equity continue to be cause for concern, especially as novel, highly efficacious treatments emerge but remain inequitably delivered. New treatments, such as immune checkpoint inhibitors, have revolutionized the management of many different cancers. Indications for their use are rapidly expanding and remain under intense investigation in clinical trials across numerous malignancies, along with their toxicity profiles and adverse event (AE) management. Altogether, immune checkpoint inhibitors bear potential hallmarks of a treatment highly susceptible to access and outcome disparities, and accumulating evidence documents barriers in access. This constellation of factors occurs at all levels, including patient, provider, healthcare system, and society.  

HCPs must understand these factors to aid in preventing and eliminating them. As health disparities often involve medications (eg, access, cost, adherence), managed care pharmacy professionals can and should urgently address these concerns. It is critical that pharmacists, including managed care professionals, are aware of healthcare disparities in immuno-oncology and are provided with education on how best to act on these findings. This symposium is designed to educate HCPs on the latest evidence-based cancer immunotherapy treatment and immune-related AE management, while also providing educational resources and training to recognize and address cancer health disparities driven by inequities due to race, socioeconomic status, sex, gender identity, and geography.

Learning Objectives 

• Identify patient populations and social determinants of health that increase risk for poor prognosis secondary to health disparities  
• Discuss management of immune-related adverse events in patient groups affected by inequalities and poor healthcare access 
• Incorporate health disparity mitigation strategies into the care of all patients receiving immune checkpoint inhibitor therapy and experiencing immune-related adverse events 
• Describe education, quality improvement, and other support strategies to ensure patients with cancer receive optimal and equitable care 

Program Manager 

Cara Blair 
ProCE  
@email 

• Provided by Pharmacy Times Continuing Education™ 
• Supported by Global Blood Therapeutics and Vertex 
• Continuing education credit available for pharmacists  
• Contact hours: 1.0 

The impact of social determinants of health affects outcomes in patients with sickle cell disease (SCD). Patients with SCD are at high risk for poor care. A study by Cole found that Black American women with SCD reported high degrees of stress and social stressors that impact their treatment and  mental health. These include racism, discrimination, violence, and poverty contributing to social and economic conditions. Overall, women of color were less likely to report good mental health than White women, and the addition of SCD to their social condition conferred a “triple burden,”" resulting in unfair treatment in the workplace and educational institutions as well as in the healthcare system. This misunderstanding of the physical and social challenges of patients of color can result in accusations of seeking treatment under false pretenses, as research has demonstrated that HCP staff unjustly suspect or accuse patients of drug dependence who present with pain crisis. Studies have shown that providers lack understanding of SCD pain, especially when treating those of lower socioeconomic status. It is crucial that HCPs and those with roles in managed care are educated on the effectiveness, safety, and economic considerations of the current treatment options and their role in improving patient outcomes and reducing healthcare resource utilization. By appreciating the issues and complications associated with SCD, managed care professionals and other HCPs will be better positioned to implement best practice strategies and tactics in the management of the disease.  

Learning Objectives 

• Illustrate the complexity of care associated with sickle cell disease (SCD) including the standards of care and treatment advances for SCD. 
• Identify the social determinants of health and associated impact on disparities in care for patients with SCD. 
• Investigate best practices to promote coordinated, long-term disease management of SCD while optimizing healthcare resources. 

Program Manager 

Kylie Ferrentino 
Pharmacy Times Continuing Education™  
@email

• Provided by Pharmacy Times Continuing Education™ 
• Supported by Janssen Biotech, Inc. 
• Continuing education credit available for Pharmacists  
• Contact hours: 1.0 

By 2044, more than half of all Americans are projected to belong to a minority group (any group other than non-Hispanic White). Inequities are observed in cancer incidence, outcomes, and mortality. Disparities in cancer care persist despite novel diagnostic and therapeutic strategies and changes in the delivery of healthcare. Health disparities are the preventable results of structural discrimination and marginalization, which, if left unaddressed, will continue to reinforce social and economic inequities, bias, and poor outcomes that affect all people. All cancer care professionals should be adequately and appropriately prepared to address the disparate health outcomes, to examine their own biases, and to participate in activities that can inform and ensure more respectful, equitable practices, research, and workplace environments. The American Society of Clinical Oncology (ASCO) policy statement on Cancer Disparities and Health Equity called for educational activities and open forums to provide critical opportunities to examine, discuss, and consider solutions to address biases on cancer health equity and the quality of cancer care delivery. The 2020 ASCO recommendations for promoting health equity include the following: (1) ensuring equitable access to high-quality care; (2) ensuring equitable access to research; (3) addressing structural barriers; and (4) increasing awareness and action. Cancer knows no race, color, nationality, gender, or ethnicity. Disparities in cancer care are expected to be exacerbated by the COVID-19 pandemic. Pharmacists, nurses, and physicians need to be educated about the multiple disparities that impact cancer both within their discipline and across professions. All cancer care professionals should be prepared to address the disparate health outcomes, to examine their own biases, and to participate in activities that can inform and ensure more respectful, equitable practices, research, and workplace environments.  

Learning Objectives 

• Identify the types of healthcare disparities within cancer care.  
• Examine perspectives of disparities in cancer care among healthcare providers. 
• Explore potential solutions to improve disparities in cancer care.  

Program Manager 

Kylie Ferrentino 
Pharmacy Times Continuing Education™  
@email 

• Provided by Pharmacy Times Continuing Education™ 
• Supported by GlaxoSmithKline 
• Continuing education credit available for pharmacists  
• Contact hours: 1.0 

An improved understanding of the molecular underpinnings of endometrial cancer has led to the development of novel treatment modalities that may help improve survival and quality of life. However, the benefit has not been equal among all population groups. The greatest opportunities for cure in endometrial cancer are primary prevention, early disease detection, and timely intervention. Patients with significant barriers and determinants to healthcare access, such as biological/genetic, environmental, behavioral healthcare, and social determinants, may not be able to take advantage of early detection and intervention. Black women present more often with advanced stages, more aggressive histologic subtypes, and are more likely to die from endometrial cancer compared with White women. This may be related to decreased access to care, less aggressive treatment, and being treated less often (less likely to undergo hysterectomy). Other populations who are at risk for health inequities with gynecologic cancers include other underserved racial and ethnic minorities, trans/gender nonconforming people, and rural populations. There is a clear need for educational activities that provide relevant perspectives on emerging data and best practices for the use of novel therapies in endometrial cancer. Managed care professionals play a key role in ensuring optimal patient outcomes through utilization of appropriate biomarker-guided treatment selection for recurrent, metastatic, and high-risk endometrial cancer. Additionally, managed care providers should be appropriately prepared to address the disparate health outcomes that exist in endometrial cancer, to examine their own biases, and to inform and ensure equality in patient care. Through this activity, managed care providers will become well-versed on the evolving treatment paradigm for endometrial cancer and solutions to address health equity and access issues in endometrial cancer care.  

Learning Objectives 

• Explore the prognosis of metastatic endometrial cancer and the significance of biomarkers in determining appropriate therapy. 
• Investigate health equity issues affecting patients with endometrial cancer and the potential impact of disparities on clinical outcomes. 
• Interpret evidence-based guidelines and clinical trial data in the use of targeted therapies for the treatment of endometrial cancer. 
• Identify best practices for implementing evidence-based treatment to maximize cost-effectiveness of immunotherapies and mitigate the disparities in health equity for patients with endometrial cancer. 

Program Manager 

Kylie Ferrentino 
Pharmacy Times Continuing Education™  
@email