Appendix A Quantifying the Potential Health and Economic Impacts of Increased Trial Diversity

Chronic illness decreases quantity of life, quality of life, and years spent in the labor force. Less appreciated is the potential for differential impact of disease for different race/ethnicity-gender groups. In other words, while chronic illness affects outcomes for all groups, some groups might experience a larger impact. The goal in this analysis is to quantify the differential impact of chronic illness for groups that have historically been underrepresented in clinical trials, as clinical trials are a potential way to identify approaches to reduce these disparities. We examine three key outcomes: quantity of life (measured by life expectancy), quality of life (measured by disability-free life), and working life (measured by years in the labor force). The thought experiment considers a hypothetical world where the differential impact is eliminated, that is, that all groups share the same impact of chronic illness.