UF College of Pharmacy researchers aim to improve health equity in diabetes care

New glucose-lowering drugs are reducing the risk of cardiovascular disease and renal complications as well as lowering mortality rates, however, the high costs associated with these medications are leading to significant equality concerns in diabetes care. Socially disadvantaged patients with lower income and education levels often struggle to access these newer treatments and social barriers can lead to disparities in diabetes care.

Drs. Guo and Shao
Drs. Serena Guo and Hui Shao

“There is an urgent need to improve the quality of care and health equity among the millions of Americans living with type 2 diabetes,” said Hui Shao, M.D., Ph.D., an assistant professor of pharmaceutical outcomes and policy in the University of Florida College of Pharmacy. “Equity should be at the forefront of diabetes care to ensure people can access the lifesaving treatments they need.”

Shao said given the high costs of the medications, it is infeasible to implement broad programs and policies that increase the use of these newer glucose-lowering drugs universally. Not all patients will benefit from the newer glucose-lowering drugs equally.  Instead, previous studies have shown that targeting patients in certain populations can have many clinical benefits and improve health equity.

“The proliferation of big real-world data, such as electronic health records and administrative claims, and recent advancements in machine learning and artificial intelligence methods, offers unique opportunities to identify individuals who will receive high clinical benefits from the newer glucose-lowering drugs,” said Serena Guo, M.D., Ph.D., an assistant professor of pharmaceutical outcomes and policy in the UF College of Pharmacy. “Thus, it is feasible to develop an algorithm to be used in health systems or health plans to stratify their patients based on the expected clinical benefit from the newer treatment. A policy-level intervention can then be designed precisely targeting the high-benefit patient subgroups to improve their drug access.”

A four-year project led by researchers in the UF College of Pharmacy, Tulane University and Cornell University aims to identify the patient groups who would benefit most from newer GLDs. Researchers will use artificial intelligence to develop an algorithm to accurately identify these patients and then target the population with policy-level interventions to increase the use of newer glucose-lowering drugs. The project will also explore ways to design health insurance plans that could potentially lead to healthier outcomes and billions of dollars in health care savings.

The National Institute of Diabetes and Digestive and Kidney Diseases is providing $2.5 million in funding for the project through an R01 grant. Shao and Guo are the co-principal investigators leading the study, while Almut Winterstein, Ph.D., R.Ph., a distinguished professor and chair of the department of pharmaceutical outcomes and policy in the UF College of Pharmacy and director of the Center for Drug Evaluation and Safety.