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Despite women making up half the population, women’s health has historically been “woefully underfunded,” accounting for less than 5% of products in the biotech development pipeline. Experts say that investors are missing out on key opportunities as a result.
To move the needle, we need to talk about women’s health.
“I think for a very long time, maybe forever, people didn’t want to talk about women’s health,” said Elizabeth Bailey, Managing Director, RH Capital, on an episode of I am BIO Podcast in 2022. “Normalizing the conversation around women’s health is essential, removing the stigma associated with talking about things that have historically made people really uncomfortable having women in decision-making roles, whether they be at venture capital funds, in industry, in research and clinical organizations, in academia—we need those voices at the table. We need them in every room where decisions are being made.”
To mark Women’s History Month, we look at how women’s health has been neglected and the opportunities for investors who take the leap.
Say the word
Women’s reproductive health historically lacks investment and has largely been limited to the development of contraceptives. Discussing menstruation, menopause, and sexual arousal disorder in women—and even using scientific terminology—has been taboo.
Sabrina Martucci Johnson, CEO of Daré Bioscience, wants to address this taboo head-on. As she explained on the I am BIO Podcast, when meeting with investors, she immediately tries to normalize the use of the word “vagina” within the initial seconds of a discussion.
“Vagina is not a four-letter word. It is a body part. It is part of the anatomy, and using the right language right away, just like we do in any other therapeutic category, really makes the whole conversation more accessible. It makes it more comfortable in mixed company if you’re using the appropriate language, immediately unashamed and just dealing with it head-on,” she said.
And history shows just how important developments in women’s reproductive health can be. As Bio.News previously reported, the Pap smear was one of the most significant medical breakthroughs in the early 20th century, allowing for early intervention and significantly reducing cervical cancer mortality rates. This, combined with the human papillomavirus (HPV) vaccine, has led to a 33% decrease in cervical cancer deaths over the past three decades.
More than reproductive health
Women’s health is more than just reproductive health. A number of health issues affect women at a notably higher percentage than men, yet are not considered women’s health issues. Case in point: autoimmune disease.
“If you look at immunology, for example, 80% of the patients are women,” Megan Greenfield, Partner at McKinsey & Co., said at the 2024 BIO International Convention. That 80% of the patient population translates to 24 million American women, resulting in about $100 billion in treatment costs annually.
Autoimmune diseases like rheumatoid arthritis, multiple sclerosis, thyroid disease, and lupus, among others, all disproportionately affect women. Notably, women are 10 times more likely to develop Hashimoto’s disease (the most common cause of hypothyroidism) than men. The ratio for lupus is 9 to 1 women to men, and for Sjogren’s syndrome (a disorder where the body mistakenly attacks moisture-secreting glands throughout the body), it’s 19 to 1 women to men.
“There is so much we still don’t know about autoimmune diseases, sex differences, and women’s health. Increased investment and research in this space has the potential to significantly improve health outcomes for women across the lifespan, while also expanding our understanding of core scientific concepts like immunity, pain, and hormones,” The Society for Women’s Health Research President and CEO, Kathryn Schubert, told Bio.News.
Focusing research in areas like these while prioritizing women’s experiences isn’t just good for women patients; it would break new ground for research areas like immunology as a whole.
Same disease, different symptoms
Another area that needs development when it comes to women’s health is diagnostics, as many diseases or healthcare crisis events manifest differently in women compared to men. This is, in part, a result of the fact that women were not historically welcomed into clinical trials in the United States—and, in fact, systematically excluded.
“In 1977, a Food and Drug Administration policy recommended excluding women of childbearing potential from Phase I and early Phase II drug trials,” the National Institutes of Health (NIH) explains. “Excluding women from early stages of drug trials led to a shortage of data on how drugs affect women. Many people believed that individual women should be allowed to choose whether to take the risk of participating in research. For example, activists protested the exclusion of women from trials of HIV drugs.”
In 1986, the NIH established a policy that encouraged researchers to include women in studies. By 1987, that policy was published widely. “In July 1989, NIH announced through a Memorandum on Inclusion that research solicitations should encourage the inclusion of women and minorities. In fact, if women and minorities were excluded, scientists should include a rationale,” the NIH explains.
Unfortunately, damage had already been done. For example, a 2020 Berkeley study found that women are nearly twice as likely as men to suffer adverse side effects of medications because drug dosages have historically been based on clinical trials conducted on men.
Additionally, when it comes to diagnostics and treatment, women find themselves with improper care. “Despite heart disease being the leading cause of death in the United States for both men and women, the medical field only recognized that women experience different symptoms of the disease than men when the American Heart Association published a Guide to Preventive Cardiology for Women in 1999,” writes the Association of American Medical Colleges (AAMC). “Separate from biological sex differences, women also are less likely to receive appropriate prevention and management of heart disease due to gender bias.”
These statistics extend to things like the implant failure rate for women getting metal hip replacements, seatbelt safety, and much more, indicating the distinct need for greater expansion of the studies of drugs and treatments across the spectrum of the sexes.
An untapped gold mine
The better news: those entering the women’s health space will likely hit paydirt.
“Investments addressing the women’s health gap could add years to life and life to years—and potentially boost the global economy by $1 trillion annually by 2040,” says a 2024 McKinsey Health Institute study.
Investors are taking note: “Women’s health investment flourished the past five years, experiencing a 314% increase in investments compared to a 28% increase in overall healthcare investments,” says a Silicon Valley Bank report. The bank called this momentum “unstoppable.”
And it seems that biotech has been heeding the call for women’s health investment compared to related industries.
“Biopharma surpassed healthtech as the top funded women’s health subsector during the last four quarters, with an average investment of $182M per quarter,” writes the bank. “Yet there remains an underrepresentation of the life sciences which comprise 66% of overall healthcare deals but only 46% of women’s health deals.”
“Innovation will drive results,” said Mary Beth Cicero, Co-Founder and CEO of 3Daughters, which develops innovation for intrauterine devices, at the 2024 BIO International Convention. “And that’s what we want investors to see.”
“I think a little bit of the disconnect is that the commercial players in women’s health aren’t creating the commercial exits as early as a venture fund would look for, or as you see in other therapeutic areas,” explained Johnson of Daré. “So the exits are happening at a very late stage, for example, by phase three FDA approval, as opposed to first human or early proof of concept—so it’s a very long valley of death.”
“We need to recognize that there are problems across the board in women’s health, and we need to ask what we do collectively to address them,” added Cicero. “And if we address them, there’s a market there, and industry will make money. That’s the bottom line.”
