By Daniel Ayubi Daniel (he/him) is a first year, pre Human Biology and Society major from the Bay Area. He’s extremely passionate about access to medicine and health policy as a whole. In his spare time, he loves watching 49ers football, spending time with friends and family, and watching Survivor. With potential to permanently alter the health field, regenerative medicine’s advancements have been, simply put, revolutionary. However, as with anything that has the potential to shape the next generation of any field, equity issues must be addressed. At best, regenerative medicine can become a new standard in medicine, accessible to all with cures for diseases previously thought incurable. At worst, it can widen the disparities between different demographics, leading to even more inequity in a society that is already plagued with rampant inequality. While there are a plethora of factors that raise concern in discussions about access to regenerative medicine, this paper will focus on socioeconomic status (SES) by both outlining how it impacts access to regenerative medicine and offering some solutions to increase accessibility. Stem cell treatments are extremely expensive. Even small injections can cost around $1,000 and more advanced procedures can cost up to $100,000 (Cona). At first glance this seems somewhat normal; medical treatments are generally very expensive. However, the key difference making stem cell treatments much more unaffordable than standard medical procedures is that they are not covered by insurance companies. This is due to the fact that insurers still classify stem cell therapy as an experimental medical treatment, which they do not cover (Boston Stem Cell Center). This includes Medicare, which currently has 62 million beneficiaries (Freed). Thus, the high cost of regenerative medicine is very concerning for patients, as it can limit access to stem cell treatments. For some context, in 2018 low income households in the United States made $48,500 or lower, while middle-income households made between $48,500 and $145,500 (Bennett). These figures were calculated using US median household income data. Moreover, that same year, premium and deductible costs comprised over 11% of median income (The Commonwealth Fund). Clearly, if middle-class Americans are already dedicating over 11% of their income (which was found to be between $48,500 and $145,000) to healthcare, it would be extremely difficult for them to pay out-of-pocket for a stem cell treatment potentially costing tens of thousands of dollars. Lower class Americans suffer the same consequence. With an income less than $48,500, any stem cell treatment would be difficult to pay for, even if a gradual payment plan is instituted. Thus, insurance companies’ current policies of not covering the costs of regenerative treatments leaves the lower and middle classes in a bind: choosing to preserve your physical health may sacrifice your financial well-being and vice versa. This is a “lose-lose” situation that increases societal inequality no matter which decision one makes. This inequality stems from the fact that the wealthy likely do not have to make this pivotal decision: they can choose to receive treatment while not having to worry about how it will impact their finances. On the contrary, every time a person with lower/middle SES decides to forego regenerative treatment due to its costs, inequality in access to regenerative treatment continues to increase. When patients are priced out of receiving the care they need due to the cost of treatments becoming so high, there is clearly a problem of social justice in play (Ellison). Clearly, cost is one of the, if not the largest barrier for those of lower/middle SES to attain access to regenerative medicine, and it needs to be addressed before regenerative medicine begins to significantly increase the inequality between classes. While cost is an extremely significant barrier inhibiting those with lower/middle SES from attaining stem cell treatments, it is by no means the only one. Lower SES groups’ lack of access to information about regenerative medicine limits their access to such treatments. This intuitively makes sense, as people are more likely to undergo a treatment that they have been exposed to. This claim is supported by the fact that members of society who have completed less education are less likely to understand the purpose of regenerative medicine (Kmiec). For clarity’s sake, it is important to remember that education level is a factor in SES, and thus those with less education completed have a lower SES. The lack of understanding explained above manifests itself in those with lower SES receiving less regenerative treatments. A study whose objective was to determine factors affecting whether or not a patient receives a needed stem cell treatment to treat either leukemia or lymphoma found that residence in a well-educated county significantly increased the likelihood of a patient receiving a stem cell transplant (Mitchell). Moreover, these stem cell transplants were found to reduce the chances of dying by almost 50% for leukemia and 70% for lymphoma (Mitchell). The findings of this study raise significant concern. While it is amazing that stem cell transplants had such a drastic effect on the chances of survival of those who underwent such treatments, it is very concerning that these medical breakthroughs are not being shared with the entire population who needs them. These concerns must be addressed before the wealthy having disproportionate access to regenerative medicine develops from a concern into the standard. Works Cited Bennett, Jesse, et al. “Are You in the American Middle Class? Find out with Our Income Calculator.” Pew Research Center, Pew Research Center, 30 July 2020, www.pewresearch.org/fact-tank/2020/07/23/are-you-in-the-american-middle-class/. Cona, Louis A. “The Cost of Stem Cell Therapy in 2021.” DVC Stem, 15 Feb. 2021, www.dvcstem.com/post/stem-cell-therapy-cost-2020. “Does Insurance Pay for Stem Cell Treatments?” Boston Stem Cell Center, www.bostonstemcell.com/does-insurance-pay-for-stem-cell-treatments/. Ellison, B. Stem Cell Research and Social Justice: Aligning Scientific Progress with Social Need. Curr Stem Cell Rep 2, 328-335 (2016). https://doi.org/10.1007/s40778-016-0063-3 Faulkner, Eric, et al. “Ensuring Patient Access to Regenerative and Advanced Therapies in Managed Care: How Do We Get There?” Journal of Managed Care Medicine, 2018, doi:10.18411/d-2016-154. Freed, Meredith, et al. “A Dozen Facts About Medicare Advantage in 2020.” KFF, 13 Jan. 2021, www.kff.org/medicare/issue-brief/a-dozen-facts-about-medicare-advantage-in-2020/. Institute of Medicine (US) Committee on the Consequences of Uninsurance. Care Without Coverage: Too Little, Too Late. Washington (DC): National Academies Press (US); 2002. 3, Effects of Health Insurance on Health. Available from: https://www.ncbi.nlm.nih.gov/books/NBK220636/ Kmiec, Eric B, and Jonathan Marron. “Potential Inequities in New Medical Technologies.” Scientific American Blog Network, Scientific American, 28 Mar. 2020, blogs.scientificamerican.com/observations/potential-inequities-in-new-medical-technologies/. Mitchell, Jean M, and Elizabeth A Conklin. “Factors Affecting Receipt of Expensive Cancer Treatments and Mortality: Evidence from Stem Cell Transplantation for Leukemia and Lymphoma.” Health Services Research, vol. 50, no. 1, 22 July 2014, pp. 197–216., doi:10.1111/1475-6773.12208. “NEW STATE-BY-STATE REPORT: Health Insurance Costs Taking Larger Share of Middle-Class Incomes as Premium Contributions and Deductibles Grow Faster Than Wages.” Commonwealth Fund, 21 Nov. 2019, www.commonwealthfund.org/press-release/2019/new-state-state-report-health-insurance-costs-taking-larger-share-middle-class#:~:text=Premium%20and%20deductible%20costs%20amounted,percent%20of%20income%20in%202018. Yap, Kiryu K. Inequality Issues in Stem Cell Medicine, vol. 5, no. 2, 23 Dec. 2015, pp. 265–266., doi:10.5966/sctm.2015-0232.
1 Comment
11/3/2023 03:01:56 am
This regenerative medicine article is a beacon of hope, brilliantly explaining how this field is reshaping healthcare. It's a testament to the potential of regenerative therapies in enhancing our well-being and quality of life. Thanks for shedding light on this groundbreaking science!
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