Dr. Andy

Reflections on medicine and biology among other things

Wednesday, August 10, 2005

Race and medicine

I've posted before about BiDil, the first medicine approved for a specific racial group (heart failure in blacks). I basically concluded that it was better to save lives than be politically correct.

This article in Nature Medicine may make me reconsider. The concern is that, with the drug approved and doctor's using it off label (for non-blacks) the company has no more incentive to understand the biology of why it works in some patients and not others.

Race is just a marker for some difference in the underlying pathophysiology of heart failure and its use suboptimal because some blacks will get it but not benefit and some non-blacks would benefit but won't get it. But now that the drug is approved, the company doesn't have as much incentive to figure this all out. Of course statistically there are probably more non-blacks who would benefit than blacks who wouldn't (just because there are many more non-blacks) but that certainly isn't as powerful an incentive as getting the drug approved in the first place.


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