Incorporating Equity into Healthcare Decision Making Around New Technologies

Abstract

Innovations in cancer care, such as the development of new pharmaceutical treatments, are widely recognized for their potential to extend lives and enhance quality of life. However, concerns persist regarding the equitable distribution of these innovations and their potential to exacerbate existing disparities in health outcomes. Moreover, the advent of cutting-edge clinical risk prediction tools presents a significant dilemma: while promising in guiding cancer treatment decisions, there is a pressing concern that these technologies could embed discriminatory biases and perpetuate racial disparities in health outcomes. Specifically, the inclusion of race as a predictive factor in these algorithms raises alarms about the potential for differential treatment across racial groups, further entrenching inequities within the healthcare systems. This study aimed to generate evidence to support the incorporation of equity considerations into healthcare decision processes surrounding these innovative developments. Aim 1 utilized a quasi-experimental approach to evaluate the impact of cancer innovations on both population-level survival and health disparities across income levels. Our findings revealed improved survival rates in lung cancer and melanoma, juxtaposed with exacerbated disparities across income levels, suggesting a plausible causal link between new innovations and health disparities. Aim 2 employed a microsimulation model to examine the long-term health disparity implications of omitting race from a colon cancer survival prediction tool. The model projected that omitting race from this tool for adjuvant chemotherapy recommendations could worsen survival for Black patients and widen the disparity gap. These findings underscore the importance of integrating equity considerations into the fabric of policies governing the evaluation, adoption, and diffusion of innovative healthcare solutions to mitigate their disparity impacts.