The Key to Better Health? Money, Money, Money

By Cindy Moy Carr, founder of mySysters

Growing up in the 1970s and ’80, a popular brand of women’s cigarettes proclaimed, “You’ve Come a Long Way Baby.”

A new report developed by McKinsey Health Institute, the World Economic Forum, and co-produced by Ferring Pharmaceuticals proves that where women’s healthcare is concerned, we still have a long way to go.

GENDER HEALTH GAP

The report shows $1 trillion gender spending gap—a gap that represents a $1 trillion economic opportunity, if only people choose to recognize it.

There’s another number in the McKinsey report, a number that gets glossed over in conversations about the lack of funding for women’s health and female founders: that $1 trillion opportunity that would change the lives of nearly 3.9 billion women.

REAL WORLD TIMELINE EXAMPLE

One oft-cited example of the healthcare gender gap is that of sildenafil citrate, aka Viagra, although that anecdote usually stops short of the full extent of the harm done.

It goes like this: In the early 1990s Pfizer repositioned its angina drug, sildenafil citrate, as a treatment for erectile dysfunction and marketed it under the name Viagra.

A group of Pfizer researchers wanted to continue studying sildenafil citrate as a treatment for dysmenorrhea (menstrual pain) but were denied.

If you’ve never experienced dysmenorrhea, you may find it helpful to know that it feels as though your insides have braided themselves together and half of the braid is twisting itself to the left and half is twisting to the right and half is trying to crawl out of your body altogether.

The pain can be so severe it can drive sufferers to suicide. Despite being a top student, my senior year of high school I missed so many days each month due to period pain the school administration threatened to not let me graduate.

DYSMENNORRHEA AS A PUBLIC HEALTH ISSUE

Pfizer did not consider dysmenorrhea a public health issue, certainly not an important one, hence the denial.

Usually this is where the anecdote ends—but let’s keep going.

We’re going to hit a real shocker, I promise.

At this same time (1993), Congress requires that women be included in clinical trials that get federal funding.

Fourteen years later (2007), in a fully funded study, sildenafil citrate is found to help hamsters recover from jet lag.

TWENTY YEARS after Congress’ ruling (2013) sildenafil citrate is shown to relieve menstrual pain, but the study runs out of funding because dysmenorrhea is not a public health issue.

WHY? Because there are no studies showing dysmenorrhea is real.

Studies for dysmenorrhea are DENIED FUNDING because there are no dysmenorrhea studies proving dysmennorhea exists.

It’s a circular argument those of us in women’s health know all too well.

BUT WAIT THERE’S MORE

That’s not the shocker I promised you. This is:

The FIRST STUDY IN HISTORY proving dysmenorrhea exists is released by Apple Health in March, 2021—one year after Viagra’s patent expires.

Apple sponsored the study to demonstrate how easy it is to track menstrual cycles on the Apple watch.

Apple showed not only that dysmennorrhea exists, but there’s a business incentive for focusing on it, making it easier for researchers to get funding for studies on dysmenorrhea.

GENDER HEALTH GAP AND LOST ECONOMIC OPPORTUNITY

Nineteen-percent of men suffer from erectile dysfunction.

Ninety-percent of women suffer from dysmenorrhea.

How many billions of dollars did Pfizer miss out on because the gatekeepers decided millions of women didn’t matter?

How many billions of dollars are corporations and investors missing out on in the near future because they’re uninformed or uninterested?

If every woman in perimenopause or menopause got together and created our own country, we’d be the third largest economy in the world.

Yet I’m still told this is a ‘niche market’ because it’s ‘just for women.’

Strange how no one ever said that about Viagra.

Let’s continue…

2021, MENSTRUAL PAIN EXISTS, SAY WHAT?!

In 2022 the National Institutes of Health in the US requires women be represented equally in medical research.

Thirty years. It took THIRTY YEARS and the government had to make it a REQUIREMENT for funding in order for companies to do it.

To put that in context, a generation in a family unit is generally considered to be 25 to 30 years.

A new generation of corporate management was in place and THERE WAS NO SIGNIFICANT CHANGE.

In 2024 McKinsey presents their report, 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, at the World Economic Forum.

The report is a difficult read, but a necessary exercise, according to Kelle Moley, OB/GYN and Ferring’s Research and Development VP of Reproductive Medicine and Maternal Health, who says it “sets out the case for change in stark terms.”

Here are just a few of the facts from the report:

THE BAD NEWS

Less than 2% of medical research funding is spent on pregnancy, childbirth and female reproductive health, leading to delayed diagnoses and worse outcomes for women compared to men.
Five times more scientific studies are funded and conducted on erectile dysfunction than dysmenorrhea when erectile dysfunction affecting an estimated 19% of men while dysmenorrhea affects 90% of women
Pharmaceutical clinical trials and research often overlook sex differences, despite data that shows women are more likely to experience adverse drug reactions
Delays in diagnosing diseases like cancer and diabetes are notably longer for women
There are severe gaps in clinical training & practice.
Every year, 70,000 women die from postpartum hemorrhage, mostly from lower and lower-middle income countries. However, that may soon change as one common treatment for postpartum hemorrhage, misoprostol, was removed from postpartum hemorrhage carts in Louisiana recently after Louisiana reclassified misoprostol and mifepristone as controlled dangerous substances. The new law is intended to prevent the two medications from being used for medical abortions. However both medications are used to treat other conditions and are not interchangeable for other indications. A woman can die from postpartum hemorrhage in as little as five minutes.

THE GOOD NEWS

At the 2024 World Economic Forum a new alliance was formed to promote women’s health. The Global Alliance for Women’s Health aims to increase investment and advance women’s health research. It also seeks to unify global leaders and stakeholders to close the gender health gap.
The profit motive is strong. Investment in women’s health is seen not only as a moral and human rights issue but also as a commercially lucrative opportunity, with significant market potential for diseases such as endometriosis.
The Biden Administration announced a $12 billion investment in women’s health research.
Along with making money for the pharmaceutical industry, closing the $1 trillion gap could prevent 24 million life-years lost due to poor health and would potentially save lives and reduce economic losses.
It’s worth noting that women represent 67% of the healthcare field globally. If that’s the case, they why aren’t they practicing medicine based on research that involves women?
To address the challenges, the report suggests that pharmaceutical companies and governments need to collaborate, overcome regulatory hurdles, and educate payors on the value of investing in women’s health. It emphasizes the need for more women in research roles and the importance of inclusive clinical trials to ensure effective and equitable healthcare solutions for women.
While the report makes one aware of the depth of the historical poor treatment of women, it also makes clear investment into women’s healthcare will benefit the bottom lines of insurance and pharmaceutical companies.

According to the report, investing in women’s health is an economic opportunity.

When it comes to investors, that’s what truly matters. But are they listening?

Sources:

https://www.nature.com/articles/d43747-024-00021-x

https://www.who.int/activities/value-gender-and-equity-in-the-global-health-workforce#:~:text=Women%20account%20for%2067%25%20of,over%20US%243%20trillion%20annually.

Read the McKinsey report here: https://www.mckinsey.com/mhi/our-insights/closing-the-womens-health-gap-a-1-trillion-dollar-opportunity-to-improve-lives-and-economies

Cindy Moy Carr is the founder and CEO of Vorsdatter Limited which created mySysters, the world’s first mobile platform for perimenopause and menopause. She’s an attorney, journalist and author, including the ABA’s Guide to Healthcare Law. She divides her time between Newcastle upon Tyne, UK, where Vorsdatter Ltd is based, and Minneapolis, MN, where the center of the universe (aka her grandchild) resides.

mySysters is an app for women in perimenopause and menopause. It was created by Cindy Moy Carr when she needed a symptom tracker for perimenopause and found there were none. She created one for herself, her sister and their friends. Hence, mySysters. Good Housekeeping and Woman’s Day named mySysters the Best App for Women in Perimenopause and a Must Have App for Women.