An Obituary for the First Race-Specific Drug
Yet after more than a year on the market, BiDil is reaching only about 1% of the 750,000 African-Americans who suffer from heart failure. Sluggish acceptance for a new drug is not unusual. But BiDil's rollout sharply illustrates how the interests of patients, insurers and drug companies can easily collide. In this case a company's decision to price a drug steeply, resistance by insurers, and a change in federal policy all proved to be impediments.
In addition to complications with Medicare and Medicaid, insurers resisted paying BiDil’s premium, which reached almost $3000 a year for some patients. This hesitancy is exacerbated by the contention that BiDil’s benefits can be achieved through taking generic forms of its components (isosorbide dinitrate and hydralazine) at a fraction of the cost.
With these disputes, the end result has been that BiDil has failed to tap into the Black heart failure market or raise substantial revenues. This led the Minnesota Daily – a hometown paper for Dr. Jay Cohn, BiDil’s creator – to recently declare the drug a “flop.”
But what’s interesting is that the Minnesota Daily’s BiDil obituary didn’t necessarily blame high prices or issues of bioequivalence as the cause for the drug’s failure. Rather, it points directly to the issues of race and political correctness.
Much of its financial failure is because of controversy over its approval for use in black patients only. Some retaliated, saying researchers had no basis to market the drug to a specific race. Cohn disagrees and says confusion surrounding the issue has crippled BiDil’s ability to treat patients who need it. “The ultimate prejudice is to not treat black people with heart failure with this drug,” he said.
Cohn’s perspective may be a bit off base. Issues of race and difference were certainly central to the BiDil debate. But those who were critical of BiDil, like myself in the CGS report Playing the Gene Card? and Dorothy Roberts (who is quoted in the Minnesota Daily piece), had issues not with the drug itself but rather how it was approved and marketed as being race-specific. We largely wanted the drug available to all unless and until there was better evidence for appending a “Blacks only label.”
Obituaries tend to lend themselves to revisionist history. But to imply that critics of BiDil are more interested in being politically correct than in helping Blacks with heart failure is a revision that goes too far.
Previously on Biopolitical Times: