Subsidies Fail to Close Racial Gap in Medication Adherence

By Chris Hoenig


Photo by Shutterstock

Older Blacks are less likely than whites to have their cholesterol under control and are less likely to use statin drugs to help lower their cholesterol, according to a University of Pittsburgh studydespite Medicare Part D subsidies that have lowered the cost of the medications.

The Part D program was started in 2006 to help close the racial gap in the use of prescription medication after studies and surveys found that Black patients were more likely to skip doses or not take medicine at all because of high costs. “It would appear that more than money is involved,” study author Joseph Hanlon said. “Racial differences in medication use are only partially explained by health insurance. Differences in quality of care, health status, patient preferences and other factors may also play a role.”

Before the subsidies went into effect, 55 percent of Blacks reported having prescription-drug coverage and 33 percent of Black study participants were already taking cholesterol drugs like Lipitor. The racial gap was obvious: 62 percent of whites had drug coverage and 49 percent were on statins to lower cholesterol.

While the amount of Black patients taking cholesterol drugs increased to 48 percent of study participants after the subsidies, the gap actually increased to 17 percentage points (65 percent of whites were taking the medications). The racial gap in insurance coverage didn’t close either, as 75 percent of Blacks and 82 percent of whites reported having prescription-drug plans.

Despite an increase in patients on cholesterol medications, average cholesterol readings went upand the racial gap widened there, too. Average LDL (“bad”) cholesterol levels went from 107 to 109 for Blacks and from 95 to 96 in whites. A reading below 130 is considered to be “under control.”

Research has already found Blacks to be at a higher risk of medical conditions related to cholesterol levels, including high blood pressure, obesity, heart disease and diabetes. Black Americans are more likely to have high blood pressure than any other racial or ethnic subset in the world, according to the American Heart Association. Nearly two-thirds of Black men and more than three-quarters of Black women are considered overweight or obese, and Blacks are also nearly twice as likely to develop diabetes as non-Latino whites.

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