You work in women’s health, even if you don’t know it

When you think of women’s health, what comes to mind? The gynecologist, mammograms, pregnancy? The truth is that it encompasses much more than reproductive health. For women, it is everything. Women’s health includes a holistic understanding of their needs, from the ways that a heart attack affects their bodies to the different way their bones age. It encompasses a woman’s full body and mind, along with the experiences and choices available to her within the larger healthcare ecosystem and society.
 

If you are working in healthcare at all—you are likely working in women’s health. This is true even if you may not focus directly on cervical cancer, fertility, endometriosis or conditions that primarily affect women.
 

We believe it’s time to expand how the industry defines women’s health. And to bring this change in mindset to pharmaceutical and medtech organizations, translating it into practical strategies to reimagine the product life cycle to better serve the well-being of nearly half of the world’s population. 

Millions of women are not receiving the standard of healthcare that they should. Across disease states, women are more likely to have their symptoms dismissed, their conditions misdiagnosed and undertreated, and live longer lives in poorer health. Women are twice as likely to die of cardiac arrest because their symptoms are more likely to go unnoticed. Women are also less likely to be resuscitated than a man. And being pregnant is the most dangerous thing that most women will do in their lifetime. Today, it is safer to be an underground mining machine operator or police officer than it is to give birth.
 

A 2021 study found that twice as much funding goes to male-prevalent diseases compared with female-prevalent ones, and only 4% of U.S. healthcare R&D spending goes directly to women’s health. For example, in the U.S., lung cancer in women accounts for 46% of deaths. Yet for every $1 spent on women’s lung cancer research, $7 is spent on men according to a report from Women’s Health Access Matters (WHAM).
 

We continue to see advances in drug development, medical technologies and patient services, but for whom? For the industry to be truly equitable and patient centric, these advances need to benefit more than just a segment of the population. Closing the gap in women’s health is not only good for the world, it’s good for the healthcare business, too. 

We know that people who identify as women face imbalances in their healthcare, in their relationships with doctors and in the healthcare products they use. That’s because the healthcare system is not built for women: It is built for men.
 

Even if the system was unintentionally built that way, we will not change the trajectory for better, more equitable healthcare outcomes for all unless we accelerate an expanded understanding of women’s health beyond their reproductive system. Women’s health encompasses their whole bodies—including everything from their lungs, bones, heart, blood, brain and skin to their mental wellness. And it is contextualized by their experiences in society and in the healthcare system.  
 

That’s why we have launched the ZS Women’s Health Expertise Hub, which partners with our clients to advance solutions specifically for women and gender-expansive individuals. ZS defines women’s health as any therapeutic area that affects women disproportionately or differently within their biology, treatment or social contexts. When we broaden the traditional definition of what constitutes women’s health, we can improve overall health outcomes for women and gender-expansive individuals by accounting for specific biological and social needs beyond a general patient pool. 

The healthcare market for conditions that only affect women is expected to grow to more than $130 billion globally by 2031. A report from WHAM estimated that investing $350 million in research would bring $14 billion back into the economy through reduced healthcare costs and improved productivity. If we applied a broader women’s health lens, imagine how much more women, society and the healthcare industry would benefit.

Investment in conditions that disproportionately and differently affect women is progressing, including investment for immunology ($180-plus billion pharmaceuticals market by 2030) and cardiovascular health ($100-plus billion device market by 2030). Femtech and digital health solutions, including pelvic floor exercise apps, wellness apps and mental health apps, have seen meaningful activity. This activity has been fueled by a variety of factors including the COVID-19 pandemic, changes in U.S. laws and shortages of healthcare resources. These events pushed more women than ever to realize that the traditional healthcare system has not been designed to meet their needs.
 

Despite these financial wins and strong projections, women’s health continues to face a lack of investment and interest outside of burgeoning digital spaces. In the last decade, some large pharma companies have begun to move away from women’s health entirely. A 2019 study found that, in the U.S. and Europe, there were 3,225 biopharma deals, with a total value of $122 billion. Only 60 of those deals over the course of the year, with a combined value of just $1.3 billion, were specific to women’s health.

How did we get here? There are historical reasons that mirror a lack of representation in other industries. There is a striking lack of power that women hold in larger healthcare and pharma organizations, and only 11% of partners in U.S. venture capital firms are women. This gender gap in leadership creates discrepancies in investment and in who controls the levers of research and product development. For example, clinical trial research did not include women of child-bearing years until 1993, and there is still a persistent belief in pharma that women are hard to recruit for clinical trials. Yet studies have found that when women lead clinical trials, these trials enroll more women (44.9%) compared to when men lead them (37.9%). This lack of representation in clinical trials means there is a significant lack of women’s health data, resulting in companies struggling to convince investors and payers of the need and viability of women’s health products. Leaders are not likely to invest in what they do not understand. 

Changing our mindset about women’s health will help shape our strategies in clinical research, product portfolios, patient services and health system development. Understanding the science within a therapeutic area is not enough; this understanding must also include women on biological and cultural levels for the industry to make meaningful progress.
 

You can start by adopting an expanded definition of women’s health for yourself and your pharma or medtech organization, which will open doors to help women experience a better quality of life. A new way of looking at women’s health can be applied in a few ways across the product life cycle:
 

Clinical research: For conditions that disproportionately or differently affect women, clinical research still overrecruits men, which exacerbates the women’s health data gap. Most clinical trials are led by men, with no significant progress in the last 15 years toward gender parity. We need to better account for barriers women experience within society, like transportation and childcare challenges, to increase the number of women participating in trials. Overall, we need to foster a deeper, more comprehensive understanding of the science of women’s biology. We should ask ourselves these questions:

• Does recruitment of women in clinical trials accurately reflect the proportion of women living with the condition?
• Are we creating conditions where women can proactively join a site for testing that consider the other obligations and expectations in her life?
• How can we promote more women to take lead principal investigator roles?
• Is our clinical research identifying or examining specific differences between men and women experiencing the same condition?
• Are we understanding the mechanism of action by gender or as a whole?
   

Market access strategy: Because clinical research processes and healthcare systems were not designed with women in mind, women often pay more out-of-pocket costs than men for essential treatments and services, such as mental health or preventive care services. Certain autoimmune conditions that disproportionately affect women (such as fibromyalgia and lupus) have historically been treated via off-label biologic treatments that leave many women spending hours on the phone working through insurance hurdles. Many insurance plans require autoimmune patients to “step through” treatments that are not compatible with pregnancy (for example, methotrexate) before they can take effective, safe, disease-modifying agents, forcing women to address child-bearing plans before they are ready or jump through insurance hoops for a medical exception. We should ask ourselves these questions:

• How can we think more holistically about the costs women will have to face—from drugs to services—to create a more equitable healthcare system?
• How can we create more inclusive access strategies that think about women, especially women of child-bearing age, from the start?
• What clinical research do payers need to see (such as gender desegregated data) to have confidence in the benefit of extending coverage for women’s health?
   

Patient and consumer marketing: In primary market research, we can do a better job of talking to women as a full person, not just a patient. There are times where women respondents have their baby on their knee during a research interview; rather than seeing this as a distraction, researchers can see it as a data point. If we can also include the nuances of women’s experiences within our marketing tools (such as brand guidelines, journeys and personas), we can do a better job of creating campaigns, communications and marketing that speak to women on every level and reflect their authentic experiences. We should ask ourselves these questions:

• Are we acknowledging their unique challenges within society when we ask questions of women and evaluate our patient research?
• Are we understanding the differences women are experiencing within their disease state?
• Are we understanding the cultural layer women are living in and how it relates back to their condition?
• Could we improve the patient and doctor dialogue?
   

Patient services: Women have different needs and preferences for patient services because of the social expectations they experience outside of being a patient. For example, women are overwhelmingly still taking their kids to the pediatrician, yet they have less access to cars for transportation. Looking through this lens when creating patient services or support programs can improve their experience as a patient or caregiver and increase their access. We should ask ourselves these questions:

• How can we help women specifically understand vaccine schedules?
• What if we understand their nuanced anxieties around vaccines?
• How can we focus on the idea that patients are people when creating patient services or programs?
• Do our services address the unique needs women experience when living with the conditions we treat? 

Women constitute 50% of the U.S. population. They control 60% of personal wealth and make 80% of healthcare decisions for themselves and their loved ones. Recognizing the pivotal role of women in society and healthcare, it’s clear that relegating women’s health to a niche industry is outdated and short-sighted. We believe that adopting this broader definition of women’s health is a first step toward making healthcare more equitable for women by addressing their unique health needs and experiences.
 

As we navigate the complexities of healthcare, it’s time to transcend outdated perceptions and invest in a future that views women’s well-being as a priority. By adopting comprehensive approaches in clinical research, product portfolios and patient services, we can enhance the quality of care and contribute to economic growth and productivity. Taking a more equitable approach to women’s healthcare opens doors to innovation and inclusivity, ultimately driving successful outcomes for life sciences organizations and, more importantly, for the world.