Words by Jade Williams
Data suggests that over 80% of medical research is done for, and carried out by, men. To be fit for purpose, R&D efforts must consider gender nuances, and there’s a long way to go to bring balance to R&D efforts within pharma
Women’s health is a journey. From birth to puberty and pregnancy to menopause, female health, at its most basic level, follows this trajectory of fertility. But that’s by no means its only feature, with countless paths and unexpected detours leading to these destinations and beyond.
“There is more to women’s health than getting a period and getting pregnant,” says Tania Boler, Founder and CEO, Elvie, speaking at WIRED Health 2022. “But obviously there is a huge amount of opportunity in that space.” Indeed, for women, reproductive health is the therapeutic area most focused on and funded for the simple reason that when designing and developing pharmaceutical products, “you need to find problem areas which have a high enough prevalence to cause disease burden”, Boler adds.
While reproductive health is important, other health concerns can go under-represented due to a lack of a holistic approach. Boler notes, for example, one in three women experience pelvic floor issues that can lead to chronic back pain, but the true cause of this back pain often goes undiagnosed.
A path less trodden
This all points to a multitude of missed opportunities that could stem from incongruities in research and funding. A 2021 study considering gender disparity in the funding of diseases by the US National Institutes of Health revealed that the funding pattern favours males in nearly three-quarters of cases where a disease afflicts primarily one gender, with overfunding for so-called ‘male diseases’ and underfunding for women’s.
Also speaking at WIRED Health 2022, Christina Pagel, Professor of Operational Research and Director of the Clinical Operational Research Unit, UCL, states that health and health research is traditionally built around men, but “it should be compulsory for regulators to include women in their research”. If they are not present from the initial R&D stages, women’s health issues will get stuck at a red light.
It should be compulsory for regulators to include women in their research
This can be seen through the lens of wearable technology, for example. Pagel highlights that while the increasing innovation in health tech over recent years has largely been beneficial, many devices do not accurately reflect gender differences in their data. The devices “read [data] as a man”, she says. “If my body temperature goes up, it thinks I am sick, not that I am ovulating or pregnant or in perimenopause. It is literally not able to read the datasets.” Omitting these female-specific health nuances during R&D stages leaves ample room for inaccurate readings and results.
But gender isn’t the only evidence of intersectionality. Also speaking at the conference, Professor Pragya Agarwal, Behavioural and Data Scientist and Visiting Professor of Social Inequities and Injustice, Loughborough University, comments that the data collected in R&D efforts is not segregated, “so even if we consider women, they are seen as a homogenous category”, and the assumption is that “the normative value is a 20-plus or 30-plus white woman”. Research into women’s health must encompass different ethnicities, ages and backgrounds to be relevant to all.
Women of colour are four times more likely to die in childbirth than their white counterparts, for example, and a lack of research into this matter means this is unlikely to improve and could even worsen. Pharma must not only ensure it is conducting research hand in hand with women, but that it is also acknowledging intersectionality and digging deeper into women’s health differences overall.
On this note, Agarwal concludes: “There is a responsibility within the sector to think about [women’s health] more holistically.” At a time when women’s autonomy over their own bodies is under threat more than ever, pharma needs to turn the corner and push towards a more equitable future.
This article features in GOLD 23 – read the full issue here.