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Opinion: The biotech industry needs to pay more attention to women’s health

STAT logo STAT 12/8/2017 Sabrina Johnson and Jessica Grossman

Even as new forms of contraception, fertility treatments, and therapies for vaginal health are emerging, there is a dearth of investment in women’s health. Despite a slew of initial public offerings and new players, including Agile, Daré, Juniper, Myovant, and ObsEva over the past few years, women’s biotech isn’t yet on everyone’s radar.

Per capita spending on women’s health was 24 percent more than spending on men’s health in 2015. Yet investment in women’s health startups is measured in millions of dollars, not billions, and less than 5 percent or so of venture capital investment goes to women-led companies.

As CEOs of two companies intent on developing and commercializing new therapies for women’s reproductive health, we are intimately aware of the dynamics that foster and inhibit growth in the women’s biotechnology sector. We see three key reasons why women’s health has only just started to take off as a dedicated area within the biotechnology sector.

The gender gap in biotech leadership

It should come as no surprise that many women’s health biotech companies are led by women. Across all biotech companies, though, under 10 percent of chief executive roles are filled by women.

Why does this matter? Women and men think differently, particularly when it comes to their own health. There are a variety of crucial life stages and choices that women experience — menstruation, pregnancy, family planning, menopause and hormone therapy for it — that men do not experience firsthand. That may mean they’re simply less likely to be aware of the value in creating new category-leading therapies that expand options. As more women rise to positions of leadership within the biotech sector, we can help educate our male peers on the health needs we have and how innovation can help.

Read more:There’s just one female CEO among San Diego’s public biotechs. Here’s why

Take the birth control pill as an example. The round blister pack of hormonal pills has long been a de facto choice for women. Yet the pill must be taken every day, it can interact with medications, and simple human error can cause its effectiveness to plummet and lead to unintended pregnancy. Millennial women in particular — especially those who have a thoughtful agenda for their education, career, and family, and who are in tune with lifestyles of health and sustainability — are eager to find longer-acting and more convenient options.

Another consideration that’s often missing in biotech are issues of access to health care that women are more likely to face than men. With many contributing factors, including a persistent wage gap for women, women are more likely to need medical aid and access health care through public programs like Medicaid — in fact, women comprise the majority of Medicaid beneficiaries. Innovative biotechs need to think about the entire health care ecosystem and engineer how women will access their products.

The underrepresentation of women in clinical trials

Medical innovation builds on existing research and scientific understanding. But it was only in the 1990s that the government established guidelines and passed legislation aimed at ensuring that women are represented in federally funded studies.

Birth Control Pills: The birth control pill has long been seen as a "good enough" contraceptive option. But many women are eager to find longer-acting and more convenient options. © APStock The birth control pill has long been seen as a "good enough" contraceptive option. But many women are eager to find longer-acting and more convenient options.

In any area of innovation, companies follow the body of research or evidence available. So the underrepresentation of women in clinical trials has had scientific repercussions in the ability to pursue new developments in conditions specific to women. Everyone involved in clinical research, whether federally funded or biotech funded, must stay focused on not only enrolling women in clinical research but also on designing studies that meaningfully elucidate potential sex differences in treatments.

It’s only with an accumulating body of data that we will be able to inform more personalized therapies for women.

Read more:Women need answers on drug use during pregnancy. Here’s how to improve research

‘One size fits all’ approaches

For far too long, medicine has followed a one-size-fits-all approach. Without leaders and investors who have a mindset for women’s health, the industry will have a persistent blind spot for identifying innovations that can translate into marketplace opportunities.

And it isn’t just that women often need different treatments than men. The advent of personalized medicine has opened the door for new and important treatments. Differences in biology, genetics, health history, demographics, and ethnicity drive diverse sub-groupings among women that warrant uniquely designed therapies. The thinking that medicines can, and should, be more personalized, combined with technologies that help us better develop them — genetic sequencing, machine learning, and the like — will lead to a broader array of personalized medicines for women.

Moving forward

We are optimistic about the future of women’s health. More companies for women — led by women — are springing up. Venture capitalists and bankers are increasingly drawn to this area, with investments in women’s health startups steadily increasing since 2011.

At the same time, women continue to be chief health care decision-makers for their households. In this position, women are increasingly looking at therapeutic benefits, cost, and convenience when making treatment decisions for themselves and their loved ones. This signals a need to develop therapies for women that not only improve their health and well-being but that are cost effective and easy to use.

As we move forward, the industry must take note at how slowly progress has been made in women’s health to date and help pave the way for increased innovation. When advances in treatments and access allow women to better control their fertility and avoid unintended pregnancy, they can finish their education, enter the workforce, and gain more economic freedom. That’s good for women and the economy.

Supporting research and development in women’s health makes good sense and cents.

Sabrina Johnson is CEO of Daré Bioscience. Jessica Grossman is CEO of Medicines360.

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