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width="1.25rem" xmlns="http://www.w3.org/2000/svg"><polyline points="6 9 6 2 18 2 18 9"></polyline><path d="M6 18H4a2 2 0 0 1-2-2v-5a2 2 0 0 1 2-2h16a2 2 0 0 1 2 2v5a2 2 0 0 1-2 2h-2"></path><rect x="6" y="14" width="12" height="8"></rect></svg></a></button></div></div><div><div class="flex flex-wrap"><p class=" text-primary font-semibold">Commentary</p><div class="h-[16px] border-l-2 border-gray-400 mt-1 mx-1"></div><p class=" text-primary font-semibold">Podcast</p><div class="h-[16px] border-l-2 border-gray-400 mt-1 mx-1 "></div><time class="text-gray-500 " dateTime="2024-11-21T21:56:03.878">November 21, 2024</time></div><h1 class="text-[26px] font-medium leading-8">Frameworks for Advancing Health Equity: Wellness Way</h1><div class="py-3 text-gray-600 md:flex flex-col md:justify-between"><div class="flex flex-col xs:flex-row"><p class="mr-1 self-start">Author(s):</p><div class="flex flex-col xs:flex-row mb-3 md:mb-0"><div class="flex flex-wrap"><span class="text-md mr-2"><a class="text-author text-gray-500 hover:text-primary underline hover:no-underline decoration-gray-400" href="/authors/giuliana-grossi">Giuliana Grossi</a></span></div></div></div><div class="max-w-full"><div class="flex flex-wrap sm:flex-nowrap items-center w-fit my-2"></div><div class="w-full flex flex-col sm:flex-row justify-between mt-2"><div class="block md:hidden "><div class="mt-2 flex items-center max-w-fit"><button title="Frameworks for Advancing Health Equity: Wellness Way" aria-label="facebook" class="react-share__ShareButton" style="background-color:transparent;border:none;padding:0;font:inherit;color:inherit;cursor:pointer"><svg viewBox="0 0 64 64" width="32" height="32"><circle cx="32" cy="32" r="31" fill="#3b5998"></circle><path d="M34.1,47V33.3h4.6l0.7-5.3h-5.3v-3.4c0-1.5,0.4-2.6,2.6-2.6l2.8,0v-4.8c-0.5-0.1-2.2-0.2-4.1-0.2 c-4.1,0-6.9,2.5-6.9,7V28H24v5.3h4.6V47H34.1z" fill="white"></path></svg></button><button aria-label="twitter" class="react-share__ShareButton" 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class="relative max-w-[300px]"><span style="box-sizing:border-box;display:inline-block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:relative;max-width:100%"><span style="box-sizing:border-box;display:block;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;max-width:100%"><img style="display:block;max-width:100%;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0" alt="" aria-hidden="true" src="data:image/svg+xml,%3csvg%20xmlns=%27http://www.w3.org/2000/svg%27%20version=%271.1%27%20width=%2799.68181818181819%27%20height=%2751%27/%3e"/></span><img src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="intrinsic" class="shrink-0" style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%"/><noscript><img srcSet="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F18674f7d86036948ef48387a848a28e043458fa3-215x110.png%3Ffit%3Dcrop%26auto%3Dformat&w=128&q=75 1x, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F18674f7d86036948ef48387a848a28e043458fa3-215x110.png%3Ffit%3Dcrop%26auto%3Dformat&w=256&q=75 2x" src="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F18674f7d86036948ef48387a848a28e043458fa3-215x110.png%3Ffit%3Dcrop%26auto%3Dformat&w=256&q=75" decoding="async" data-nimg="intrinsic" style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%" class="shrink-0" loading="lazy"/></noscript></span></div></a></div></div><p class="py-2 mb-2 text-sm italic text-gray-600">The Wellness Way facility was designed to improve access to comprehensive outpatient care and address social determinants of health for a diverse patient population.</p><div class="py-2"><div class="blockText_blockContent__TbCXh"><p class="pb-2">This episode of Managed Care Cast from <em>The American Journal of Managed Care</em><sup class="text-inherit">®</sup> is part of the Frameworks for Advancing Health Equity series from the <a target="_blank" href="https://www.ajmc.com/topic/center-on-health-equity-and-access">Center on Health Equity and Access</a>, setting the stage for a deep dive into program initiatives across the US dedicated to mitigating health care disparities by closing the accessibility gap.</p><p class="pb-2"></p><p class="pb-2">Elizabeth Warner, MD, FACS, MHCDS, chief medical officer of Capital District Physicians’ Health Plan (CDPHP), delves into the Wellness Way initiative—a collaborative effort between CDPHP and the largest independent physician practice in the region, Community Care Physicians (CCP). The new health care facility was designed to improve access to comprehensive outpatient care and address social determinants of health for a diverse patient population.</p><p class="pb-2"></p><p class="pb-2">Warner discusses how the center's focus on patient experience, community partnerships, and integration of physical and mental health care services sets it apart from traditional hospital-based care.</p><div style="min-height:700px"><noscript>Please enable Javascript</noscript></div><p class="pb-2"><a rel="nofollow" target="_self" href="https://podcasts.apple.com/us/podcast/managed-care-cast/id1177540313">iTunes</a><br/><a rel="nofollow" target="_self" href="https://tunein.com/podcasts/Health--Wellness-Podcasts/Managed-Care-Cast-p937637/">TuneIn</a><br/><a rel="nofollow" target="_self" href="https://www.stitcher.com/podcast/managed-care-cast">Stitcher</a><br/><a rel="nofollow" target="_self" href="https://open.spotify.com/show/7JQZGTuflqnkt8wjfX238y">Spotify</a></p></div></div><div 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href="/view/-expanding-access-isn-t-just-about-fairness-it-s-about-building-better-treatments-for-everyone-?utm_source=www.ajmc.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/fb378f5c2512ec02d9e7ea46c60aab1649c99dba-305x305.jpg?fit=crop&auto=format" alt="Regina Barragan-Carrillo, MD | Image: Photo provided by ASCO" width="288" class="jsx-ad50481d5ee26850 max-h-[200px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">February 16th 2025</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/-expanding-access-isn-t-just-about-fairness-it-s-about-building-better-treatments-for-everyone-?utm_source=www.ajmc.com&utm_medium=relatedContent">"Expanding Access Isn’t Just About Fairness—It’s About Building Better Treatments for Everyone”</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/regina-barragan-carrillo-md">Regina Barragan-Carrillo, MD</a><span class="jsx-ad50481d5ee26850 mr-1 ml-[1px]"> </span><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/interview-by-mary-caffrey">Interview by Mary Caffrey</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/-expanding-access-isn-t-just-about-fairness-it-s-about-building-better-treatments-for-everyone-?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">Regina Barragan-Carrillo, MD, a postdoctoral fellow at City of Hope Comprehensive Cancer Center, discussed findings that show 76% of renal cell carcinoma trials take place in wealthy countries, amid news that clinical trial access for the world's poor may become even more challenging.</div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/telemedicine-s-evolution-and-expanding-access-to-obesity-and-specialty-care?utm_source=www.ajmc.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/9de113904a026205cbaf84d08420c4065d52fd67-1000x563.jpg?fit=crop&auto=format" alt="Telemedicine’s Evolution and Expanding Access to Obesity, Specialty Care" width="288" class="jsx-ad50481d5ee26850 max-h-[200px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">February 11th 2025</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/telemedicine-s-evolution-and-expanding-access-to-obesity-and-specialty-care?utm_source=www.ajmc.com&utm_medium=relatedContent">Telemedicine’s Evolution and Expanding Access to Obesity, Specialty Care</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/maggie-l-shaw">Maggie L. Shaw</a><span class="jsx-ad50481d5ee26850 mr-1 ml-[1px]"> </span><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/george-jones">George Jones</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/telemedicine-s-evolution-and-expanding-access-to-obesity-and-specialty-care?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">George Jones of UpScript Health discusses telemedicine's evolution from basic e-prescribing to real-time video consultations, expanding treatment beyond primary care.</div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex md:hidden justify-center items-center"></div><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/mitigating-barriers-to-cell-and-gene-therapy-access?utm_source=www.ajmc.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/0e9f2afc4fce72b7b0848f9cafeb4014fca633ff-1200x800.jpg?fit=crop&auto=format" alt="The authors emphasized the importance of early diagnosis and treatment with CGTs, especially for patients with genetic conditions. | Image credit: RFBSIP - stock.adobe.com" width="288" class="jsx-ad50481d5ee26850 max-h-[200px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">February 14th 2025</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/mitigating-barriers-to-cell-and-gene-therapy-access?utm_source=www.ajmc.com&utm_medium=relatedContent">Mitigating Barriers to Cell and Gene Therapy Access</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/rose-mcnulty">Rose McNulty</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/mitigating-barriers-to-cell-and-gene-therapy-access?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">Cell and gene therapies can be life-changing for patients with certain conditions, but the process of receiving them poses barriers for patients and caregivers that require multistakeholder solutions, according to a white paper from the National Pharmaceutical Council. </div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/politics-vs-science-the-future-of-us-public-health?utm_source=www.ajmc.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/9de113904a026205cbaf84d08420c4065d52fd67-1000x563.jpg?fit=crop&auto=format" alt="Managed Care Cast Logo" width="288" class="jsx-ad50481d5ee26850 max-h-[200px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">February 4th 2025</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/politics-vs-science-the-future-of-us-public-health?utm_source=www.ajmc.com&utm_medium=relatedContent">Politics vs Science: The Future of US Public Health</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/maggie-l-shaw">Maggie L. Shaw</a><span class="jsx-ad50481d5ee26850 mr-1 ml-[1px]"> </span><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/perry-n-halkitis-phd-ms-mph">Perry N. Halkitis, PhD, MS, MPH</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/politics-vs-science-the-future-of-us-public-health?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">On this episode of Managed Care Cast, we speak with Perry N. Halkitis, PhD, MS, MPH, dean of the Rutgers School of Public Health, on the public health implications of the US withdrawal from the World Health Organization and the role of public health leaders in advocating for science and health.</div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/talapro-2-overall-survival-data-suggest-new-standard-of-care-in-mcrpc-regardless-of-genomic-status?utm_source=www.ajmc.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/948100d9eb716a5d39097a7cbd5c0b5b8da8fd2e-800x640.jpg?fit=crop&auto=format" alt="Neeraj Agarwal, MD, FASCO | Image credit: LinkedIn" width="288" class="jsx-ad50481d5ee26850 max-h-[200px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">February 14th 2025</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/talapro-2-overall-survival-data-suggest-new-standard-of-care-in-mcrpc-regardless-of-genomic-status?utm_source=www.ajmc.com&utm_medium=relatedContent">TALAPRO-2 Overall Survival Data Suggest New Standard of Care in mCRPC, Regardless of Genomic Status</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/mary-caffrey">Mary Caffrey</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/talapro-2-overall-survival-data-suggest-new-standard-of-care-in-mcrpc-regardless-of-genomic-status?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">Positve overall survival data could lead to a label expansion for Pfizer's combination to treat metastatic castration-resistant prostate cancer (mCRPC).</div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/adults-with-depression-likely-develop-physical-conditions-30-faster?utm_source=www.ajmc.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/e05603a90031c8d9b811698d3e417c77bf163061-1280x800.jpg?fit=crop&auto=format" alt="Hands psychology and mental health with a woman in a therapy session for grief counseling after loss Anxiety stress or depression with a female patient feeling nervous in a clinic for support-KApeopleimages-stock.adobe.com.jpeg" width="288" class="jsx-ad50481d5ee26850 max-h-[200px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">February 13th 2025</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/adults-with-depression-likely-develop-physical-conditions-30-faster?utm_source=www.ajmc.com&utm_medium=relatedContent">Adults With Depression Likely Develop Physical Conditions 30% Faster</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/giuliana-grossi">Giuliana Grossi</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/adults-with-depression-likely-develop-physical-conditions-30-faster?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">The large UK Biobank study finds depression a significant risk predictor for developing chronic conditions such as osteoarthritis, hypertension, and gastro-oesophageal reflux disease.</div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div></div></div></div><div class="relative hidden sm:block"><div class="mt-4 overflow-hidden"><div class="flex justify-between"><div class="flex items-center clear-both pt-4 pb-2 text-3xl lg:text-2xl xl:text-3xl min-w-fit ">Related Content </div><div class="hidden lg:flex w-full flex-col justify-end items-end"><div class="hidden w-full lg:flex flex-wrap pb-2 gap-x-2 gap-y-1 justify-end items-end"></div></div></div><div class="w-full mb-2 border border-secondary"></div><div class="lg:hidden flex flex-wrap items-center"></div><div class="flex flex-wrap w-full"><div class="jsx-ad50481d5ee26850 w-full h-full"><div><div><div class="text-[8px] text-center text-gray-500 hidden">Advertisement</div><div id="div-gpt-ad-infeed-1"></div></div></div><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/-expanding-access-isn-t-just-about-fairness-it-s-about-building-better-treatments-for-everyone-?utm_source=www.ajmc.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/fb378f5c2512ec02d9e7ea46c60aab1649c99dba-305x305.jpg?fit=crop&auto=format" alt="Regina Barragan-Carrillo, MD | Image: Photo provided by ASCO" width="288" class="jsx-ad50481d5ee26850 max-h-[200px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] 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href="/view/-expanding-access-isn-t-just-about-fairness-it-s-about-building-better-treatments-for-everyone-?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">Regina Barragan-Carrillo, MD, a postdoctoral fellow at City of Hope Comprehensive Cancer Center, discussed findings that show 76% of renal cell carcinoma trials take place in wealthy countries, amid news that clinical trial access for the world's poor may become even more challenging.</div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/telemedicine-s-evolution-and-expanding-access-to-obesity-and-specialty-care?utm_source=www.ajmc.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/9de113904a026205cbaf84d08420c4065d52fd67-1000x563.jpg?fit=crop&auto=format" alt="Telemedicine’s Evolution and Expanding Access to Obesity, Specialty Care" width="288" class="jsx-ad50481d5ee26850 max-h-[200px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">February 11th 2025</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/telemedicine-s-evolution-and-expanding-access-to-obesity-and-specialty-care?utm_source=www.ajmc.com&utm_medium=relatedContent">Telemedicine’s Evolution and Expanding Access to Obesity, Specialty Care</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/maggie-l-shaw">Maggie L. Shaw</a><span class="jsx-ad50481d5ee26850 mr-1 ml-[1px]"> </span><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/george-jones">George Jones</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/telemedicine-s-evolution-and-expanding-access-to-obesity-and-specialty-care?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">George Jones of UpScript Health discusses telemedicine's evolution from basic e-prescribing to real-time video consultations, expanding treatment beyond primary care.</div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex md:hidden justify-center items-center"></div><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/mitigating-barriers-to-cell-and-gene-therapy-access?utm_source=www.ajmc.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/0e9f2afc4fce72b7b0848f9cafeb4014fca633ff-1200x800.jpg?fit=crop&auto=format" alt="The authors emphasized the importance of early diagnosis and treatment with CGTs, especially for patients with genetic conditions. | Image credit: RFBSIP - stock.adobe.com" width="288" class="jsx-ad50481d5ee26850 max-h-[200px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">February 14th 2025</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/mitigating-barriers-to-cell-and-gene-therapy-access?utm_source=www.ajmc.com&utm_medium=relatedContent">Mitigating Barriers to Cell and Gene Therapy Access</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/rose-mcnulty">Rose McNulty</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/mitigating-barriers-to-cell-and-gene-therapy-access?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">Cell and gene therapies can be life-changing for patients with certain conditions, but the process of receiving them poses barriers for patients and caregivers that require multistakeholder solutions, according to a white paper from the National Pharmaceutical Council. </div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/politics-vs-science-the-future-of-us-public-health?utm_source=www.ajmc.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/9de113904a026205cbaf84d08420c4065d52fd67-1000x563.jpg?fit=crop&auto=format" alt="Managed Care Cast Logo" width="288" class="jsx-ad50481d5ee26850 max-h-[200px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">February 4th 2025</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/politics-vs-science-the-future-of-us-public-health?utm_source=www.ajmc.com&utm_medium=relatedContent">Politics vs Science: The Future of US Public Health</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/maggie-l-shaw">Maggie L. Shaw</a><span class="jsx-ad50481d5ee26850 mr-1 ml-[1px]"> </span><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/perry-n-halkitis-phd-ms-mph">Perry N. Halkitis, PhD, MS, MPH</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/politics-vs-science-the-future-of-us-public-health?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">On this episode of Managed Care Cast, we speak with Perry N. Halkitis, PhD, MS, MPH, dean of the Rutgers School of Public Health, on the public health implications of the US withdrawal from the World Health Organization and the role of public health leaders in advocating for science and health.</div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/talapro-2-overall-survival-data-suggest-new-standard-of-care-in-mcrpc-regardless-of-genomic-status?utm_source=www.ajmc.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/948100d9eb716a5d39097a7cbd5c0b5b8da8fd2e-800x640.jpg?fit=crop&auto=format" alt="Neeraj Agarwal, MD, FASCO | Image credit: LinkedIn" width="288" class="jsx-ad50481d5ee26850 max-h-[200px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">February 14th 2025</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/talapro-2-overall-survival-data-suggest-new-standard-of-care-in-mcrpc-regardless-of-genomic-status?utm_source=www.ajmc.com&utm_medium=relatedContent">TALAPRO-2 Overall Survival Data Suggest New Standard of Care in mCRPC, Regardless of Genomic Status</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/mary-caffrey">Mary Caffrey</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/talapro-2-overall-survival-data-suggest-new-standard-of-care-in-mcrpc-regardless-of-genomic-status?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">Positve overall survival data could lead to a label expansion for Pfizer's combination to treat metastatic castration-resistant prostate cancer (mCRPC).</div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/adults-with-depression-likely-develop-physical-conditions-30-faster?utm_source=www.ajmc.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/e05603a90031c8d9b811698d3e417c77bf163061-1280x800.jpg?fit=crop&auto=format" alt="Hands psychology and mental health with a woman in a therapy session for grief counseling after loss Anxiety stress or depression with a female patient feeling nervous in a clinic for support-KApeopleimages-stock.adobe.com.jpeg" width="288" class="jsx-ad50481d5ee26850 max-h-[200px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">February 13th 2025</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/adults-with-depression-likely-develop-physical-conditions-30-faster?utm_source=www.ajmc.com&utm_medium=relatedContent">Adults With Depression Likely Develop Physical Conditions 30% Faster</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/giuliana-grossi">Giuliana Grossi</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/adults-with-depression-likely-develop-physical-conditions-30-faster?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">The large UK Biobank study finds depression a significant risk predictor for developing chronic conditions such as osteoarthritis, hypertension, and gastro-oesophageal reflux disease.</div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div></div></div></div><div class="pb-24"></div></div><script type="application/ld+json">{"@context":"https://schema.org","@type":"NewsArticle","headline":"Frameworks for Advancing Health Equity: Wellness Way","datePublished":"2024-11-21T21:56:03.878Z","dateModified":"2024-11-21T21:56:09Z","inLanguage":"en-US","image":"https://cdn.sanity.io/images/0vv8moc6/ajmc/a1728e6a06fccde8af20d2308f860344f9776b8f-800x400.jpg?fit=crop&auto=format","mainEntityOfPage":{"@type":"WebPage","@id":"https://www.ajmc.com/view/frameworks-for-advancing-health-equity-wellness-way"},"publisher":{"@type":"Organization","name":"AJMC","logo":{"@type":"ImageObject","url":"https://www.ajmc.com/ajmc_logo_inverted.png"}},"keywords":"CDPHP,Podcast,health equity,Health care access","articleBody":"This episode of Managed Care Cast from The American Journal of Managed Care® is part of the Frameworks for Advancing Health Equity series from the Center on Health Equity and Access, setting the stage for a deep dive into program initiatives across the US dedicated to mitigating health care disparities by closing the accessibility gap.\n\n\n\nElizabeth Warner, MD, FACS, MHCDS, chief medical officer of Capital District Physicians’ Health Plan (CDPHP), delves into the Wellness Way initiative—a collaborative effort between CDPHP and the largest independent physician practice in the region, Community Care Physicians (CCP). The new health care facility was designed to improve access to comprehensive outpatient care and address social determinants of health for a diverse patient population.\n\n\n\nWarner discusses how the center's focus on patient experience, community partnerships, and integration of physical and mental health care services sets it apart from traditional hospital-based care.\n\n\n\niTunes\nTuneIn\nStitcher\nSpotify","description":"The Wellness Way facility was designed to improve access to comprehensive outpatient care and address social determinants of health for a diverse patient population.","author":[{"@type":"Person","name":"Giuliana Grossi"}]}</script></div></div><div class="flex-none w-[300px] z-[9999] relative hidden md:block"><div style="top:5rem" class="sticky custom-spacing"><div class="collapse-container " style="overflow:hidden;max-height:900px;transition:max-height .4s ease-in-out"></div></div></div></div><div id="div-gpt-ad-pixel" style="width:1px;height:1px" 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challenging.","body":[{"children":[{"_type":"span","marks":[],"text":"Global health has seen plenty of upheaval in recent weeks. 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Then came the decision by the Trump administration to all but shutter the US Agency for International Development (USAID), which brought at least 30 international "},{"text":"clinical trials","_key":"d8787b960d7c","_type":"span","marks":["1566406d8129"]},{"_key":"103207f0d079","_type":"span","marks":[],"text":" to a sudden halt."}],"_type":"block","style":"normal","_key":"7d696f4aa693","markDefs":[{"nofollow":false,"blank":true,"_type":"link","href":"https://www.ajmc.com/view/heath-equity-access-weekly-roundup-january-27-2025","_key":"27083d128cff"},{"blank":true,"_type":"link","href":"https://www.nytimes.com/2025/02/06/health/usaid-clinical-trials-funding-trump.html","_key":"1566406d8129","nofollow":true}]},{"markDefs":[{"_type":"link","href":"https://www.sciencedirect.com/science/article/abs/pii/S1078143923002910","_key":"d117ed4bf960","nofollow":true,"blank":true},{"nofollow":false,"blank":true,"_type":"link","href":"https://www.ajmc.com/conference/asco-gu","_key":"a2e6f58a72b2"},{"_key":"845ca425b5ca","nofollow":false,"blank":true,"_type":"link","href":"https://www.ajmc.com/view/amid-debate-over-diversity-rcc-trials-still-struggle-to-reflect-patient-populations"}],"children":[{"text":"All this provided an ironic backdrop for Regina Barragan-Carrillo, MD, a postdoctoral fellow at City of Hope Comprehensive Cancer Center, who this week presented results that show clinical trials in renal cell carcinoma (RCC) mostly take place in wealthy countries, even though poverty is ","_key":"e26684e7288a","_type":"span","marks":[]},{"_type":"span","marks":["d117ed4bf960"],"text":"strongly linked to poor outcomes","_key":"259fa7552cea"},{"_type":"span","marks":[],"text":" in this disease. Barragan-Carrillo ","_key":"b660f32651ba"},{"marks":["845ca425b5ca"],"text":"presented her findings","_key":"e8df96881494","_type":"span"},{"_key":"100deebc18c8","_type":"span","marks":[],"text":" at the "},{"_key":"fa534cd5cb56","_type":"span","marks":["a2e6f58a72b2"],"text":"American Society of Clinical Oncology Genitourinary Cancers Symposium"},{"_type":"span","marks":[],"text":" (ASCO GU), held February 13-15, 2025, in San Francisco, California.","_key":"ca47aaa64790"}],"_type":"block","style":"normal","_key":"8bf71a0889aa"},{"style":"normal","_key":"58abe502f620","markDefs":[{"blank":true,"_type":"link","href":"https://lazarex.org/state-of-diversity-in-cancer-clinical-trials-2024/","_key":"4960f46ef5a7","nofollow":true}],"children":[{"_type":"span","marks":[],"text":"ASCO, as well as the National Cancer Institute and the FDA, have called for both academic investigators and pharmaceutical companies to take steps to ensure that clinical trial enrollment for new therapies more closely matches the population of patients who will take the drugs. But data show it’s been an uphill battle. The ","_key":"5f77edf8930c"},{"_type":"span","marks":["4960f46ef5a7"],"text":"Lazarex Foundation","_key":"a9b9b13640d2"},{"_type":"span","marks":[],"text":" reported in 2024 that Black patients make up 5% of clinical trial participants, although they are 13% of the US population, and Hispanic patients are only 1% of trial participants even though they are 16% of the population.","_key":"2d258855d265"}],"_type":"block"},{"imgcaption":[{"_key":"b0495dd0cbb5","markDefs":[],"children":[{"text":"Regina Barragan-Carrillo, MD | Image credit: ASCO","_key":"ec7da1c61a78","_type":"span","marks":[]}],"_type":"block","style":"normal"}],"widthP":30,"disableTextWrap":false,"_type":"figure","alt":"Regina Barragan-Carrillo, MD | Image credit: ASCO","asset":{"_ref":"image-fb378f5c2512ec02d9e7ea46c60aab1649c99dba-305x305-jpg","_type":"reference"},"disableLightBox":true,"_key":"25c7448ab70d","alignment":"right"},{"_type":"block","style":"normal","_key":"5e03a0216bd3","markDefs":[{"_key":"bd8d730d348a","nofollow":true,"blank":true,"_type":"link","href":"https://school.wakehealth.edu/features/research/making-clinical-trials-more-accessible-to-underserved-populations#:~:text=Location%20is%20key,her%20treatment%2C%E2%80%9D%20explained%20Thomas."}],"children":[{"_type":"span","marks":[],"text":"Barragan-Carrillo’s study focuses on a key problem: too many studies ","_key":"c997868dd4f2"},{"_type":"span","marks":["bd8d730d348a"],"text":"don’t go where the patients are","_key":"46797aebcfbc"},{"_type":"span","marks":[],"text":". ","_key":"3e17faa9a53d"},{"_type":"span","marks":["em"],"text":"The American Journal of Managed Care","_key":"c7e0df6fc349"},{"_type":"span","marks":["sup"],"text":"®","_key":"bc6fe991c306"},{"marks":[],"text":" (","_key":"6f09db41e5d4","_type":"span"},{"_type":"span","marks":["em"],"text":"AJMC","_key":"a2cb77789e25"},{"_type":"span","marks":["sup"],"text":"®","_key":"3eff012875b6"},{"_type":"span","marks":[],"text":") spoke with Barragan-Carrillo in San Francisco during ASCO GU about her findings and their importance, given the shifting landscape over support for diversity and equity initiatives in health care.","_key":"ebaa5b85cae2"}]},{"style":"normal","_key":"dea18df93819","markDefs":[],"children":[{"text":"This interview has been lightly edited for clarity.","_key":"8e5c3e7e2171","_type":"span","marks":["em"]}],"_type":"block"},{"children":[{"_type":"span","marks":[],"text":"","_key":"56a7b736fc05"}],"_type":"block","style":"normal","_key":"56c515e51d26","markDefs":[]},{"style":"normal","_key":"cc75fb59a06c","markDefs":[],"children":[{"_key":"8c193e201565","_type":"span","marks":["strong","em"],"text":"AJMC"},{"marks":["strong"],"text":": ","_key":"18a2799e64a7","_type":"span"},{"_type":"span","marks":[],"text":"What do we know about the connections between RCC and poverty?","_key":"1374d76981d3"}],"_type":"block"},{"children":[{"_key":"dbe795cd2f0f","_type":"span","marks":["strong"],"text":"Barragan-Carrillo: "},{"text":"We know that lower socioeconomic status is linked to both a higher risk for developing RCC and worse survival outcomes. And these survival outcomes are dependent on later diagnosis and worse access to care, as well as less access to novel systemic therapy.","_key":"7051ddefe1ea","_type":"span","marks":[]}],"_type":"block","style":"normal","_key":"a992c6ceb3eb","markDefs":[]},{"markDefs":[],"children":[{"text":"For example, here in the US, Black patients [with RCC] have a 16% higher mortality rate compared with their non-Hispanic White counterparts. In Arizona, when we’re talking about patients from Latino origins, it's been documented that these patients are twice as likely to be diagnosed in advanced stages and have nearly double the risk of dying from early-stage disease compared with non-Hispanic White patients.","_key":"82ef87b587dd","_type":"span","marks":[]}],"_type":"block","style":"normal","_key":"b8d5d6ad49e7"},{"style":"normal","_key":"d1444acd5172","markDefs":[],"children":[{"_type":"span","marks":[],"text":"This does not stop at the individual-patient level. On a global scale, people that come from lower-income face even greater barriers to care, with 5-year survival rates up to 50% lower than in wealthier countries. There definitely is an important risk, not only from a biological standpoint, but more from contamination and exposure to environmental factors that could increase the risk for developing the RCC. Access to care also plays a very important role.","_key":"90793999dbd1"}],"_type":"block"},{"children":[{"_type":"span","marks":["strong","em"],"text":"AJMC","_key":"a21fd4bd85b2"},{"marks":["strong"],"text":":","_key":"45a71810a0df","_type":"span"},{"marks":[],"text":" Your findings show that 76% of the trials in RCC were conducted exclusively in high-income countries and that none were available in low-income countries. Beyond the fact that the trials fail to reflect racial and ethnic diversity, what knowledge do we lack about drug delivery in low-income countries when we fail to include them in trials?","_key":"410f86197ad1","_type":"span"}],"_type":"block","style":"normal","_key":"635238af799c","markDefs":[]},{"markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Barragan-Carrillo: ","_key":"436cad64c9ad"},{"_key":"4cc25d58c196","_type":"span","marks":[],"text":"So, what do we not learn about that process when we don't do the trials in low-income countries? We do not learn a lot, to be quite frank with you, when these trials are not conducted in all sorts of backgrounds. In low-income countries, we are missing critical information about how the treatments work in the real-world setting, but also how drug distribution works."}],"_type":"block","style":"normal","_key":"adbc1fa82052"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"For example, how do we ensure that hospitals have the right capability to handle the drug, to have the correct refrigeration system to ensure the quality of the drug is going to be maintained; that it [matches] the quality when they were doing the research in high-income countries. The fact that we're not annotating for that, and we don't have the evidence to support it, also leads to fewer opportunities to improve it.","_key":"cb746b952f42"}],"_type":"block","style":"normal","_key":"bf2e25d01598"},{"style":"normal","_key":"0b583d2b7e76","markDefs":[],"children":[{"_type":"span","marks":[],"text":"It's going to be very hard to have specific steps to improve the quality of care, even for patients who are living in remote areas of the US. We’re missing out on a lot of critical information.","_key":"d66c43111d58"}],"_type":"block"},{"markDefs":[],"children":[{"text":"AJMC:","_key":"a9fe081c9bb0","_type":"span","marks":["strong","em"]},{"text":" What are some other challenges with drug delivery that we could learn about during a clinical trial?","_key":"4d28c160ab25","_type":"span","marks":[]}],"_type":"block","style":"normal","_key":"cd9a0b84d7bb"},{"style":"normal","_key":"752ffa51f07a","markDefs":[],"children":[{"marks":["strong"],"text":"Barragan-Carrillo: ","_key":"d576685abcc6","_type":"span"},{"_type":"span","marks":[],"text":"Many patients in [low-to-middle-income countries] have coexisting conditions, such as malnutrition, parasitic infection, or environmental exposures, that do not happen in high-income countries that could alter the drug’s effectiveness. It’s hard to pinpoint a single thing, but the one sure thing is that populations do look very different across the US and across the globe—so all these external factors that are seen more often in other countries are not being shown in the clinical trials. And we're not sure if the interventions that have proven to be effective for patients living in high-income countries are going to be as effective for patients living in other regions of the world.","_key":"0149cbbd64a1"}],"_type":"block"},{"children":[{"marks":["strong","em"],"text":"AJMC:","_key":"f439294a8dea","_type":"span"},{"_type":"span","marks":[],"text":" Your results highlight the disproportionate role that pharma plays in funding trials. Almost all the time, pharma sponsors trials for their own investigational drugs—not for generic drugs that low-income countries would be more likely to afford. Whose job should it be to maintain the infrastructure to pay for those kinds of studies?","_key":"ee5049a95785"}],"_type":"block","style":"normal","_key":"0c3b836d163a","markDefs":[]},{"markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Barragan-Carrillo: ","_key":"d2ba07c4aa3f"},{"_type":"span","marks":[],"text":"That’s the million-dollar question, to be completely honest. Right now, no one is really taking ownership. If I can be very transparent, pharma companies clearly do focus on the profit and the patent in drug trials, meaning they rarely invest in trials for generics. And even though generics could be game changers for low-income countries, it's something that does not have an economic interest where we ask ourselves, “Who should be the one stepping up?” It has to be a collaborative effort.","_key":"a38cd9ef841d"}],"_type":"block","style":"normal","_key":"9d399fcd14c1"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"First, governments must take a more active role, particularly through public health care agencies and funding bodies and international agencies. For example, the WHO should step up to help coordinate the effort and establish funding mechanisms. [Nongovernmental organizations] have a role to play, especially in implementation; patient advocacy and public and private partnerships can offer a way forward, pairing the infrastructure and expertise from the industry with the public sector funding and global priorities.","_key":"8600bf3972c2"}],"_type":"block","style":"normal","_key":"3f7a8f189114"},{"_type":"block","style":"normal","_key":"a12458b5b191","markDefs":[{"blank":true,"_type":"link","href":"https://dndi.org/","_key":"cc1661a23871","nofollow":true}],"children":[{"_type":"span","marks":[],"text":"An important example that I love to highlight is the ","_key":"38f1da1e2d8c"},{"_type":"span","marks":["cc1661a23871"],"text":"Drugs for Neglected Diseases initiative","_key":"1bda41775c0b"},{"_type":"span","marks":[],"text":". It’s a very good model, in the sense that it brings together different stakeholders to fund research on diseases that are disproportionately affecting low-income regions. We need to do something similar in the space of not only RCC, but oncology in general to help patients worldwide.","_key":"9f2af5e5f912"}]},{"style":"normal","_key":"5f236b678968","markDefs":[],"children":[{"marks":["strong","em"],"text":"AJMC:","_key":"2c5e760781fe","_type":"span"},{"text":" Why should it matter to wealthy countries for poor countries to have access to clinical trials? How does everyone benefit when everyone has access?","_key":"293b81b92773","_type":"span","marks":[]}],"_type":"block"},{"markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Barragan-Carrillo: ","_key":"ba0de3aebef3"},{"_type":"span","marks":[],"text":"First, I think of fairness. Cancer is just not a problem of wealthy countries, so why should clinical research be concentrated there? If we test new therapies only in high-income settings, we end up with treatments that may not be applicable, accessible, or even effective in a large portion of the world's population.","_key":"9f5c45e06bf6"}],"_type":"block","style":"normal","_key":"4188b56cd54f"},{"_type":"block","style":"normal","_key":"6a97b32b7eee","markDefs":[],"children":[{"marks":[],"text":"Right now, we're overwhelmingly concentrated in high-income countries, which is leaving out the majority of the world's patients who have cancer; 70% to 75% of all new cancer cases are happening in lower- and middle-income countries, so we're talking about almost three-quarters of our worldwide patient population. And expanding access isn't just about being fair; it’s also about making treatments better, stronger, and more effective for everyone.","_key":"f0a773a12fe3","_type":"span"}]},{"markDefs":[],"children":[{"marks":[],"text":"Beyond equity, there are scientific benefits to expanding clinical trials globally. Genetic diversity matters, and it matters a lot in oncology. It matters a lot when you talk about pharmacodynamics and pharmacokinetics; the way patients respond to different cancer treatments can vary a lot on the genetic background, environmental exposures, and underlying health conditions. Including low-income countries in trials gives us more representation on data, and it leads to better and more universally effective treatments.","_key":"e661ad7f500a","_type":"span"}],"_type":"block","style":"normal","_key":"e5c8f37cc26d"},{"_key":"202c7797ed27","markDefs":[],"children":[{"marks":[],"text":"Another thing I’d like to mention is that we learn how to make treatments in health care environments. Not every country is going to have the same access to high-tech imaging, robotic surgery, or expensive immunotherapies. Understanding how to adapt the treatments for different levels of health care infrastructure can help make them more scalable and more accessible worldwide.","_key":"f1e357fffc60","_type":"span"}],"_type":"block","style":"normal"},{"style":"normal","_key":"3341e9fa237e","markDefs":[],"children":[{"marks":["strong","em"],"text":"AJMC:","_key":"9f89ce4d1407","_type":"span"},{"_type":"span","marks":[],"text":" So, we might actually learn how to do things in a less expensive way?","_key":"28c67b213c16"}],"_type":"block"},{"markDefs":[],"children":[{"_key":"5614872d703c","_type":"span","marks":["strong"],"text":"Barragan-Carrillo: "},{"marks":[],"text":"Yes, 100%. There’s what we call reverse engineering, where we learn how to adapt certain information in a lower-income setting and then we bring it back to a higher-income setting to be more much more cost-effective. That can allow patients to have access to are without so much financial toxicity.","_key":"6ce152e988e7","_type":"span"}],"_type":"block","style":"normal","_key":"f5a221f7654d"},{"markDefs":[],"children":[{"_type":"span","marks":["strong","em"],"text":"AJMC:","_key":"44d3d6de2b4f"},{"text":" Obviously, you were working on this study for a long time. But you happen to be presenting these results just as the new administration is pulling back on personnel, on funding that supported a lot of this kind of research, and on the infrastructure that supported this work. Many of these decisions, of course, are being contested. What are the implications of presenting your research now, in this changing environment?","_key":"2027dd419be3","_type":"span","marks":[]}],"_type":"block","style":"normal","_key":"b58c0612b0dd"},{"style":"normal","_key":"732147884602","markDefs":[],"children":[{"text":"Barragan-Carrillo: ","_key":"5c13537c901e","_type":"span","marks":["strong"]},{"marks":[],"text":"I think scaling back this type of funding, it's a major step in the wrong direction. From a scientific point of view, cutting funding from whole global health research doesn't just slow down the progress, it actively worsens these priorities. The broader implications are quite concerning. It could mean less innovation….","_key":"8fb9d0c9c9ee","_type":"span"}],"_type":"block"},{"style":"normal","_key":"4bbc4f9ccb65","markDefs":[],"children":[{"text":"This could lead to worse patient outcomes. If trials only happen in wealthy regions, we'll continue to see major inequities in who benefits from scientific answers. 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The study also indicates that these individuals not only showed a higher burden of physical illness but continued to accumulate conditions, such as osteoarthritis, hypertension, and gastro-esophageal reflux disease (GERD), at an accelerated rate."}],"_type":"block","style":"normal","_key":"dfbd143f596e"},{"_key":"deb969c7a160","alignment":"right","asset":{"_ref":"image-e05603a90031c8d9b811698d3e417c77bf163061-1280x800-jpg","_type":"reference"},"alt":"Hands psychology and mental health with a woman in a therapy session for grief counseling after loss Anxiety stress or depression with a female patient feeling nervous in a clinic for support-KApeopleimages-stock.adobe.com.jpeg","widthP":38,"imgcaption":[{"_key":"7d09d4d4e691","markDefs":[],"children":[{"_type":"span","marks":[],"text":"Results show an association between depression and chronic physical illness.","_key":"f3daca89fa2a"}],"_type":"block","style":"normal"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"Image Credit: KApeopleimages - stock.adobe.com","_key":"f5b9f51483f3"}],"_type":"block","style":"normal","_key":"b9b47d4ffb49"}],"disableLightBox":true,"_type":"figure","disableTextWrap":false},{"_key":"88c43ac1c30f","markDefs":[],"children":[{"text":"Researchers assessed 69 long-term physical conditions using self-reports, primary care records, hospital admissions, cancer registries, and death records. 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","_key":"b8c27300e788"},{"_key":"2340de5f4e9c","_type":"span","marks":["em"],"text":"PLoS Med"},{"_type":"span","marks":[],"text":". 2025;22(2):1004532. doi:10.1371/journal.pmed.1004532","_key":"8cb03a7f755d"}],"_type":"block","style":"normal","_key":"a22dc1df0e86","markDefs":[]},{"markDefs":[{"_type":"link","href":"https://www.nimh.nih.gov/health/publications/chronic-illness-mental-health","_key":"c3cb6f82fc22","nofollow":true,"blank":true}],"children":[{"_type":"span","marks":[],"text":"2. National Institute of Mental Health. Understanding the Link Between Chronic Disease and Depression. U.S. Department of Health and Human Services, National Institutes of Health. 2024. Accessed February 13, 2025. 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