Race-Specific Medicine

Is medicine a black or white matter? Increasingly, pharmaceutical manufacturers are acting as if it is. At least 30 drugs now on the market are claimed by manufacturers to be safer or more effective for African Americans than for whites. Most commonly, these are drugs that proved ineffective in rigorous testing but that (perhaps accidentally) appeared to work in small studies of African Americans—some of which didn’t even compare African Americans with whites. Yet as Chapter 3 discussed, there are no meaningful genetic differences between “races,” so there are no biological explanations for these supposed differences in drug safety or efficacy. Indeed, one major review concluded that manufacturer’s claims for “race specific” drugs are “universally controversial”.

In addition to increasing drug costs as patients are shifted from older, less expensive drugs to newer and perhaps ineffective drugs, the rise of race-specific medicine reinforces the idea that racial differences are real and important. Moreover, when drug companies focus on seeking racial differences, they may unintentionally hide more important causes of illness: Poor African Americans living in polluted neighborhoods in Mississippi, for example, may be no more susceptible to disease than their white neighbors, but this may be overlooked if researchers divide their subjects only by race and not by pollution levels. Similarly, the concept of race-specific medicine may lead doctors to quickly assign diagnoses and treatments based on race rather than on a holistic assessment of their patients as individuals. In fact, more than 80% of doctors responding in a national survey agreed that race should be used as a basis for diagnosis and treatment.