The Article in Brief

BiDil: Assessing a Race-Based Pharmaceutical

By Howard Brody, MD, PhD, and colleague

Background BiDil is the first drug approved by the FDA and marketed for a single racial-ethnic group, African Americans, in the treatment of congestive heart failure. This essay explores background issues to help prepare family physicians to counsel patients about this controversial drug. Issues include the following: (1) The scientific research leading to BiDil's approval tested the drug only in African Americans, apparently for commercial reasons, so the drug's effectiveness in other populations is not known. (2) Race can be an important factor in considering risk of certain diseases and health care disparities in American medicine; however, we should not assume that differences in the occurrence of diseases among racial or ethnic groups are due to genetic differences. BiDil is an example of how the contribution of social and cultural factors in the causes of a disease may be overlooked because of an assumption of a "racial" and genetic difference. (3) BiDil is a profit-making venture. Doctors could consider prescribing lower-cost generic options.