Women do not always benefit from the same quality of treatment or care as men, which can lead to delayed, inappropriate or even non-existent care. This is why women’s health is both a medical and a public health issue, and one in which pharmaceutical companies have a key role to play. In this article, Alcimed explores this subject, which is still poorly addressed and concerns many therapeutic areas beyond gynecological and reproductive health, as well as proposes levers for action for pharmaceutical companies.
The first thing that comes to mind when we talk about women’s health is all the health issues specific to women, i.e. those directly linked to the gynecological sphere (menstruation, menopause, endometriosis), reproductive (fertility, pregnancy) or “female” cancers (breast, cervix, ovaries).
Today, these health topics represent a strong medical need. On the one hand, medical research is still insufficient: only 4% of the pharmaceutical industry’s R&D investment is devoted to women’s health issues. By comparison, specific research into prostate cancer alone accounts for 2% of total funding.1https://bigmedia.bpifrance.fr/news/quest-ce-que-la-femtech On the other hand, numerous obstacles such as a long and complex diagnostic process or a limited number of therapeutic options, as in the case of endometriosis, still need to be resolved if women are to gain access to high-quality, appropriate care.
It would be a mistake to reduce women’s health to the gynecological and reproductive sphere.
The second aspect of women’s health that deserves to be better known and considered is the disparity in care experienced by women because of their gender, for diseases or non-gender-specific health issues (i.e., issues that concern both sexes). This includes disparities in risk prevention, diagnosis, treatment and/or follow-up. Because these disparities are most often unfavorable to women, they are a source of inequality in care and therefore represent a priority public health issue.
Cardiovascular disease is the leading cause of death in women, killing 200 women in France and 25,000 worldwide every day.2https://www.portailvasculaire.fr/espace-sfmv/actualite/le-bus-du-coeur-des-femmes#:~:text=En%20France%2C%20les%20maladies%20cardio,de%20d%C3%A9pistage%20%C3%A9tait%20mieux%20d%C3%A9fini. However, sex/gender disparities do exist, since women are twice as likely as men to have an unfavorable outcome, or even to die, following a cardiovascular event, and the time taken to reach hospital after the first symptoms appear is 38 hours longer for women than for men.3Acute coronary syndromes in women and men (Nature, 2016) – Table 1 et “Delay in presentation”
These disparities can be explained by :
Among the general public, cardiovascular disease is still seen as a man’s disease, and women are more focused on breast cancer than cardiovascular disease (despite the fact that the latter kills 8 times more women than breast cancer).4https://www.fedecardio.org/presse/les-francaises-et-les-maladies-cardiovasculaires/#:~:text=Selon%20une%20enqu%C3%AAte%20r%C3%A9alis%C3%A9e%20par,que%20le%20cancer%20du%20sein.
Within the medical profession, doctors tend to associate women’s symptoms of heart trouble (such as tightness in the chest) with emotional causes (stress, anxiety…), three times more than for the same symptoms presented by men, and therefore prescribe anxiolytics rather than a cardiological consultation.5https://www.haut-conseil-egalite.gouv.fr/IMG/pdf/rapport_sexe_genre_soigner-v9.pdf
Women have a higher cardiovascular risk, both because of their specific hormonal risk (contraception, pregnancy, menopause) and because risk factors such as diabetes and smoking have a greater impact on women. This additional risk is underestimated and therefore poorly addressed today.
Women may present symptoms that are atypical for a heart attack (sweating, vomiting, shortness of breath, etc.), different from those of men (chest or shoulder pain), and which are unfortunately not recognized as such neither by the medical profession nor by women themselves (80% of women are unaware of these female symptoms)6https://axalive.fr/article/axa-prevention-sante-femmes-cardiovasculaire, which slows down or falsifies their diagnosis.
Pain (acute and chronic) is a second example of a therapeutic area where sex/gender disparities are strong and often to the disadvantage of women. Numerous studies have documented these disparities, which are present at all levels of the care pathway, and are summarized by Alcimed in the diagram below:
As with cardiovascular disease, there are two main reasons for the wide disparities in pain:
For example:
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In this context, pharmaceutical companies can act on three levels:
Contribute to research to generate gendered data on the study of diseases
Sensitize healthcare professionals to gender issues in health and to female symptoms of disease, and work with them to adapt screening and diagnostic approaches to women’s specific needs.
Raise awareness among the general public and patients, in particular by combating preconceived ideas.
Ensure inclusiveness and diversity in patient recruitment for clinical trials.
Integrate sex and gender into the study of pharmacological properties, efficacy and safety of drugs, taking into account the impact of female physiology and hormones.
Work with the medical profession to recognize and reduce gender stereotypes in prescribing behavior.
Work with healthcare professionals and patients to adapt follow-up programs to women’s specific needs, particularly in terms of secondary/tertiary prevention.
Addressing the issue of women’s health requires taking a new perspective on health and medicine, and therefore represents an opportunity for pharmaceutical companies to innovate. By exploring their strategic challenges (screening and diagnosis, care pathways, access, personalized medicine, digital health, etc.) through a different prism, pharmaceutical companies can imagine and develop new offers and solutions, notably by initiating collaborations with new players, such as start-ups and biotechs in the FemTech sector, expert and dedicated organizations like “Agir pour le cœur des femmes” (in France) or simply experts – doctors, academics, patients – on women’s health issues.
Improving women’s health means recognizing and addressing the disparities, both sex- and gender-related, that exist in medicine to the disadvantage of women. The key challenge today is to broaden the definition of “women’s health” beyond purely gynecological issues to include all areas affected by these disparities, such as cardiovascular and respiratory diseases and pain. Pharmaceutical companies active in these therapeutic areas have a role to play in providing innovative solutions and improving knowledge, management and awareness at all levels of the care pathway. Alcimed can help you explore the subject of women’s health and the opportunities related to your business. Don’t hesitate to contact our team!
About the author,
Chloé, Consultant in Alcimed’s healthcare team in France.
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