The United States pays more for medical care than any other nation in the world, including for prescription drugs. These costs are inequitably distributed, as individuals from underrepresented racial and ethnic groups in the U.S. experience the highest costs of care and unequal access to high quality, evidence-based medication therapy. “Pharmacoequity” refers to equity in access to pharmacotherapies, or ensuring that all patients, regardless of race and ethnicity, socioeconomic status, or availability of resources, have access to the highest quality of pharmacotherapy required to manage their health conditions. Herein we describe the urgent need to prioritize pharmacoequity. This goal will require a bold and innovative examination of social policy, research infrastructure, patient and prescriber characteristics, as well as health policy determinants of inequitable medication access. In this article, we describe these determinants, identify drivers of ongoing inequities in prescription drug access, and provide a framework for the path towards achieving pharmacoequity.
Key Points
Question
How were ambulatory quality, patient experience, utilization, and cost associated with implementation of the Patient Protection and Affordable Care Act (ACA)?
Findings
In this nationally representative cross-sectional study of 123 171 individuals, the ACA was associated with more high-value diagnostic and preventive testing, improved patient experience and access, and decreased out-of-pocket expenditures for lower income US individuals. The ACA was not associated with changes to most quality measures, utilization, or the total cost of care.
Meaning
These findings suggest that policy makers and health system leaders seeking to further improve value should combine insurance expansion with additional policy initiatives to see broader improvements in care.
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