Specialty Drug Use Varies by Race and Wage

New research presented at AMCP Nexus 2023 indicates that race and ethnicity and wage-related disparities may be related to lower use of specialty medications in some patients with autoimmune conditions. This likely contributes to inequitable outcomes that have been documented among non-White and low-income populations who have employer-sponsored insurance.

“The relationship between wage, race/ethnicity, and specialty medication use among employees with autoimmune conditions is poorly understood. Insights into demographic variations in specialty medication use can inform health equity improvement efforts,” wrote the authors, led by Rochelle Henderson, PhD, vice president of research at the National Pharmaceutical Council in Washington, DC.

The researchers conducted an observational, retrospective cohort study to identify any associations between race, ethnicity, or wages and patterns of specialty medication use and adherence. The population included full-time employees who had an autoimmune condition and employer-sponsored health insurance. The research team obtained data for 2018 from the IBM Watson MarketScan database.

Race and ethnicity and wage level were identified based on employer records. The researchers also collected data on specialty medications supplied for autoimmune conditions, proportion of days covered, and medication discontinuation.

The database included more than two million enrollees, and race and ethnicity data were available for 617,117 people (29.8%). Among that group, 47,839 (7.8%) had an autoimmune condition. In that targeted group, 5,358 (11.2%) had filled at least one specialty prescription for the autoimmune condition. The study found that specialty prescription use was significantly less common among Black and Hispanic employees, except those in the highest wage category. However, the proportion of days covered and discontinuation rates did not differ significantly by race and ethnicity or wage level.

Dr. Henderson encouraged attendees to consider what they are doing to address disparities in the utilization of specialty medications.


Henderson R, Phares S, Kamin L. Specialty Drug Use Varies by Race and Wage among Employees with Employer-Sponsored Health Insurance. Poster Z3. Presented at AMCP Nexus 2023; Oct. 16‒19, 2023; Orlando, Fla.