The clinical research space is one that is constantly innovating in order to bring breakthrough therapies to the patients that need them. However, on this quest for speed and innovation, some patients have been inadvertently left behind. As such, there is much to do to increase representation in clinical research to ensure that all patients can benefit from important new and novel therapies.-By Kim Persaud

Kim Ribeiro, Head, Diversity & Patient Inclusion at AbbVie is a woman with both a passion and goal for inclusion: to make sure clinical research includes diverse patients and physicians to advance healthcare outcomes in underserved populations. It is not an easy goal to reach, but she is relying on her outstanding leadership skills, experience in various positions in biopharmaceuticals, and desire to have more influence in the earlier stages of the treatment process. AbbVie is already recognized as a leader in the industry, taking on tough health challenges and pursues scientific breakthroughs through its motto of people, passion, and possibilities. The future only holds even more success through diversity, equity, and inclusion (DEI).

Natural Evolution of Progress in a Human-Centric Treatment Design

Kim Ribeiro began working at AbbVie in 2014 as Manager, Clinical Patient Recruitment and Retention, and over the next four years held positions as Therapeutic Area Lead and then Patient Centric Clinical Development and Director, Clinical Trials Diversity & Inclusion. Her degrees in biotechnology and clinical laboratory science, plus the experience gained in these positions prepared her well to assume her current position in November 2021. She now leads a team building foundational capabilities to enable the design of inclusive clinical trial programs. Kim notes that “It’s a natural evolution in the process of AbbVie to be able to build on our best practices and create more of an enterprise approach in which diversity, equity, and inclusion are practiced cross-organization.”

When Ribeiro worked at a hospital before joining AbbVie, she realized she was more on the tail end of the treatment journey for patients, and she decided she wanted more exposure upstream. Going into biopharmaceuticals gave her opportunities to work on clinical trials and have more influence in the earlier stages of the treatment process. She thinks of DEI as the best way to be human-centric about inclusion and representation right from the start of clinical trials and through all the different phases. Incremental intervention is the goal of her approach. She makes it clear she is not trying to reinvent the wheel or change the things that are working well. Ribeiro is striving to look at how AbbVie typically does business through a transformative DEI lens to ensure. to ensure everyone is thinking of inclusion from the very start and not as an afterthought. She believes in proactive planning, so she created templates that are used enterprise-wide and translate commitment into action.

Ribeiro also explains, “The default is to think about patient diversity in isolation. But we recognize there is no patient diversity in our field without the diversity of the physicians that conduct our trials. So another piece we are focusing on as a key initiative is creating the pathway for new diverse investigators. Equitable trial access isn’t just for new patients but for clinicians also.” Her team is looking at the ecosystem and ensuring unintentional roadblocks are not being created as barriers of entry for those diverse physicians who are seeing patients in the communities who want to help advance clinical trial priorities.

Willful Impactful Change to Reduce Health Disparities Making a willful, impactful change in healthcare disparities is an overdue conversation. There is awareness of the disparities that exist in the healthcare system, and it is the role of biopharmaceutical companies to determine how to bring about change through the work done. It requires being systemic in addressing changes for sustainability and not treating efforts as one-off initiatives.

What are the solutions? That is a tough question to answer. “I don’t necessarily think there is a one-size fits all solution to health inequities, explains Ribeiro, “because first, we must understand the key drivers. We know everyone has a right to be healthy, but we need to understand there are many social determinants of health that impact access to health care – cultural background, socioeconomic background, and even geographic location.” Understanding the social constructs that influence how and when people receive identifying the institutional barriers that must be overcome. Ribeiro goes on to explain, “We need a key understanding of areas in early detection and early diagnosis because these are drivers of health disparities.” People in marginalized communities have worse health outcomes because they have a late diagnosis. Investing in education and awareness around early screening and detection is a key strategy for closing the gaps in healthcare.

Designing Inclusive Research Programs Through the Power of Advocacy

“Our vision at AbbVie is to be a leader in designing inclusive research programs,” says Ribeiro, adding, “We want to be able to say that every program we offer has equitable access and trial experiences for our patients and our physicians. Particularly in the U.S., we focus on minority communities because they have been typically underrepresented. But when we talk about inclusion in clinical trials, we also go beyond race and ethnicity. We also think about age, sex, gender identity, and ensuring our representation in clinical trials reflects those patients that are living with the diseases we are studying and does not simply match national demographics or population data.”

Ribeiro and her team realize that designing and implementing inclusive research programs cannot be done in isolation. That is why a key piece is including community physicians as partners. They can help with having communities as trusted sources in clinical research and clinical trials. Ribeiro sees the power of advocacy and the power of community partnerships to help AbbVie achieve its goals. The ultimate goal is to have an enterprise approach, in which inclusion and representation are routine across clinical protocols.