Abstract
Introduction
Biologics are important options for inflammatory bowel disease (IBD) management. It has been reported that people of color (POC) with IBD are less frequently prescribed biologics compared to whites. Drug manufacturers’ websites are often designed to improve patient awareness and understanding of medical conditions and treatment. There is a paucity of information evaluating racial minorities depicted on pharmaceutical websites focused on biologic therapy. This study evaluated minority representation on websites of common biologic therapies used for IBD.
Methods
Websites for 4 major biologics were evaluated (Humira, Remicade, Stelara, Entyvio) for minority representation. Stock photos and videos were analyzed. Individuals were categorized based upon perceived ethnicity (person of color [POC], racially ambiguous [RA], white), gender, and role (patient, provider). Individuals were categorized independently by 3 investigators. Repeat images, incomplete facial images, inactive background role in videos, or images in which there was disagreement among all investigators were excluded. Statistical analysis was performed using two-sample t-test with significance set at p<0.05.
Results
In the 4 websites, there were 102 total subjects (49 photos, 53 videos). There were 89 white, 11 POC, and 2 RA subjects with 33 males (32 white, 1 POC, 0 RA) and 69 females (57 white, 10 POC, 2 RA). There were significantly less POC compared to whites in photos (14.2% vs 81.6%; p=0.0003) and videos (7.0% vs 93.0%; p=0.001). Males were less frequently represented than females in photos (33.3% vs 66.7%; p=0.0096) and videos (32.3% vs 67.7%; p=0.0238). There were no males of color in photos. Humira portrayed 10 POC, Entyvio portrayed 1 POC and none were identified on Remicade and Stelara websites. Humira included 1 white, male provider, and Remicade 1 female POC provider. Stelara and Entyvio included no providers in either photos or videos. There were no images or videos about which all 3 reviewing investigators disagreed. All websites included at least 1 image with which a single investigator disagreed. Only Humira and Vedolizumab included a video with single investigator disagreement.
Discussion
Biologic therapy has a significant role in IBD treatment and should be considered for all IBD patients who have the appropriate indications. Pharmaceutical websites can have a role in increasing patient understanding and acceptance of therapy. Patients may have increased acceptance of treatment based upon portrayed images. While this study revealed that males and POC were significantly less represented on biologic websites, it may reflect gender and minority group IBD prevalence. However, consideration should be given to increase minority representation on biologic websites to enhance male and POC acceptance of therapeutic options and potentially improve clinical outcomes.
