As life sciences companies continue to make public commitments to improve diversity, equity, and inclusion (DEI) at their organizations, one-piece needs more attention: clinical trial diversity. Clinical trial diversity must be a cornerstone for any company’s DEI-related pledge – alongside other efforts to improve the diversity of hiring, creating a more inclusive company culture, or launching and scaling a supplier diversity initiative. And although there is no one-size-fits-all solution to improve DEI within an organization, it’s hard to argue having a complete DEI commitment without including clinical trial diversity.
Looking at Massachusetts specifically, the opportunity for our companies to be a leader in clinical trial diversity is huge because the Massachusetts biopharma cluster is predominantly comprised of small and emerging biotech companies – of MassBio’s biotech company members, more than 2/3 have less than 50 employees. These companies are predominantly pre-commercial, pre-revenue, and preclinical and have the chance to build in true, comprehensive commitments to DEI as they grow so it becomes ingrained within the fabric of the company’s culture and mission.
Establishing this type of culture early on makes it increasingly straightforward to also make commitments toward more diverse clinical trials early on. This cohort of companies is taking big bets on complicated science to address the world’s greatest unmet medical needs, but you can’t accelerate drug development without considering how a particular drug affects the entire population. Before designing a clinical trial, companies must ensure minority populations who have been overlooked in the past are an integral part of the recruiting process – and it’s all about access.
Numerous barriers have hindered minority populations from accessing clinical trials – the cost of transportation, travel demands, forgone wages, and lack of awareness. If companies can remove these factors and improve communication within minority communities about how they can access clinical trials, the industry – and its stakeholders – can take significant steps towards advancing clinical trial diversity. Yet, trial sponsors can also do more to make sure their trials are diverse.
This change in strategy and operations can seem daunting, especially to a smaller biotech (and its investors). Yet, the clinical trials for the COVID-19 vaccines show running diverse trials is possible, even in the most high-profile and demanding circumstances. With the eyes of the world on them, COVID-19 vaccine manufacturers made incredibly hard choices to pause trials, stop or slow enrollment of certain populations, and other changes to increase the levels of diverse populations in the trials. It was a hard decision, but necessary and successful.
The life sciences industry has a critical responsibility in improving clinical trial diversity. People of color suffer from serious underrepresentation in clinical trials, leading to worse outcomes for minorities as drugs work differently in different patient populations, but the industry cannot act alone in addressing this. Creating policies at the local, state, and federal levels can also have a real impact. In 2020, the Massachusetts State Legislature passed legislation that would explicitly allow for reimbursement for supplementary costs of lodging and transportation associated with participating in cancer clinical trials, including the costs of anyone accompanying the patient. Similar legislation should be replicated in other states and used as an example of how removing financial and socioeconomic barriers can have a real, lasting impact on improving health equity by allowing more diverse populations to participate in clinical trials.
As companies in the life sciences continue to cultivate and refine their DEI strategies, they must consider the role clinical trial diversity will play. Thinking about how to approach clinical trial diversity as early as possible in an organization’s lifecycle will help fully integrate it within DEI pledges, but any commitment requires action to be taken. The pandemic, statewide legislation, and previous company experiences can serve as great reference points – consider how you can remove barriers to improve access and develop a plan for how you will diversify clinical trials as early as possible. The breadth of success of a therapeutic or novel drug depends on it.
To learn more about how to take meaningful steps to improve DEI within your organization, visit: https://www.massbio.org/initiatives/equity-diversity-and-inclusion/.