Asian American Older Adults Face Unique Health Concerns With Hepatitis B
COMMENTARY

May 20, 2024by Clayton Fong, President and CEO, National Asian Pacific Center on Aging
Asian American Older Adults Face Unique Health Concerns With Hepatitis B
FILE - Tabs of a small-molecule drug are photographed in Greenfield, Mass., on July 23, 2018. (AP Photo/Elise Amendola, File)

Asian Americans, Native Hawaiians and Pacific Islanders account for over half of all hepatitis B patients in the United States. The harmful infection causes liver inflammation and, in severe cases, organ failure and death. Asian Americans also account for over a third of tuberculosis cases in the country. Untreated, the disease can likewise be fatal.

What do these two health conditions have in common — beyond their disproportionate impact on the AANHPI community? They are both treated with medicines known in the pharmaceutical community as small-molecule drugs.

Unfortunately, a recent legislative change has stifled the development of new drugs in this category — a blow that will hit our community disproportionately. 

Small-molecule drugs are chemical compounds that typically come in capsules or pills, like the Aspirin and ibuprofen that so many of us have in our medicine cabinets. Antibiotics and common cold medicines often fall under the same, small-molecule banner. 

Many Americans rely on these drugs to manage chronic health conditions. And many more are counting on future small-molecule drug development. For instance, Asian Americans have a higher risk of developing diabetes than White Americans. Scientists believe that future small-molecule drug discovery could result in better treatment options for diabetes patients.

Due to recent policy changes, drug makers have a far greater incentive to direct their work toward a different class of medications known as biologics, the more complex treatments derived from organic compounds typically administered in physicians’ offices.  

Biologics are important, too, and essential for treating many serious health conditions, like cancer and multiple sclerosis. However, we are concerned that the focus towards biologics will create less incentive for companies to create small-molecule drugs that are beneficial to our community.  

The reason for the bias towards biologics? Recent policy changes created a 13-year exemption for biologics, compared to nine years for small-molecule drugs.

We are already seeing the impact of this arbitrary time difference. As just one example, Pfizer recently announced plans to prioritize biologics over small molecule projects.

Small-molecule drugs are readily available at the pharmacy counter. They can be taken at home, without the need to travel to a clinic or other health care center. Our communities often lack access to reliable transportation, and some individuals have limited English proficiency, making travel potentially daunting.

We urge Congress to equalize the exemption period for small molecule and biologic drugs.

Doing so will level the playing field for pharmaceutical companies to create drugs that are beneficial and easier to access for the Asian American, Native Hawaiian and Pacific Islander older adult community.


Clayton Fong is president and CEO of the National Asian Pacific Center on Aging and lives in the greater Seattle, Washington, area. He can be reached on LinkedIn.

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