Eliminating Health Disparities in Atrial Fibrillation, Heart Failure, and Dyslipidemia: A Path Toward Achieving Pharmacoequity

Abstract

Purpose of review: Pharmacoequity refers to the goal of ensuring that all patients have access to high-quality medications, regardless of their race, ethnicity, gender, or other characteristics. The goal of this article is to review current evidence on disparities in access to cardiovascular drug therapies across sociodemographic subgroups, with a focus on heart failure, atrial fibrillation, and dyslipidemia.

Recent findings: Considerable and consistent disparities to life-prolonging heart failure, atrial fibrillation, and dyslipidemia medications exist in clinical trial representation, access to specialist care, prescription of guideline-based therapy, drug affordability, and pharmacy accessibility across racial, ethnic, gender, and other sociodemographic subgroups. Researchers, health systems, and policy makers can take steps to improve pharmacoequity by diversifying clinical trial enrollment, increasing access to inpatient and outpatient cardiology care, nudging clinicians to increase prescription of guideline-directed medical therapy, and pursuing system-level reforms to improve drug access and affordability.

Keywords: Atrial fibrillation; Diversity; Dyslipidemia; Heart failure; Pharmacoequity.

Figure 1.. Opportunities to improve pharmacoequity along the therapeutic continuum.

This figure represents important steps in the therapeutic continuum where barriers to pharmacoequity exist in the US healthcare system. Each of these steps can be viewed as an opportunity to improve access to high-quality care for patients with CVD. Figure is adapted from the prior pharmacoequity literature (42, 188).