Is it racist not to cover BiDil?

When I saw the news that the NAACP was accusing CMS of racism for not requiring Medicare Part D carriers to cover BiDil –a heart medication indicated specifically for African Americans, I was dismissive, as were others. After all, BiDil is just a combination of two generic products, commercial payers have been slow to offer coverage, and the NAACP received a $1.5 million grant from NitroMed, BiDil’s maker. Furthermore, CMS does require coverage of BiDil or its generic components.

But after thinking some more about it, and reading an article on how African Americans receive less thorough evaluation for chest pain in the ER…

Overall, African American men were 25% to 30% less likely to receive ECGs and x-rays as well as cardiac rhythm and oxygen saturation monitoring using pulse oximetry than non-African American men (white or other race).

…I can better understand the NAACP’s sentiment. After all, BiDil is far from the only patented drug based on non-novel molecules, NitroMed isn’t the only company with aggressive marketing tactics, NAACP isn’t the only organization receiving grants from interested parties, and there is evidence of discrimination elsewhere in the system.

It’s still not obvious to me that BiDil coverage should be mandated, but the wider context is worth considering.

February 6, 2007

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