“….much of modern medicine is built on research performed exclusively on male bodies, and the effects of this research gap are serious–sometimes even deadly.”
Prianka Jain and Laine Bruzek, Fortune Magazine article June 10, 2022
In almost every aspect of the world, male bodies have always been the default–from office air conditioning to crash test dummies. But nowhere is that default more dangerous than in medical research. Women are diagnosed significantly later than men on average across over 700 diseases, sometimes waiting up to 10 years for the proper diagnosis.
I’m ashamed that I was completely unaware of this disparity in research funding and focus until two articles hit my inbox in the same week. One was from Dr. Bertalan Mesko and his team at The Medical Futurist Institute, and the other was a Fortune Magazine article quoted above. The reasons for the “gender gap” in health research and its funding are historical. And we don’t even need to go back centuries, only a few decades, to find some interesting things. In the United States, women were not required to be included in clinical research until June 10, 1993, when Congress passed the NIH Revitalization Act. That means that much of modern medicine is built on research performed exclusively on male bodies, and the effects of this research gap are serious–sometimes even deadly.
Centuries of unconscious bias and lack of research have created a public health crisis where women are often dismissed, misdiagnosed, or prescribed the wrong treatment. It’s a perfect storm of implicit bias in clinical settings, a shortage of women’s health research, and a lack of funding for female-focused solutions. Only 4% of healthcare R&D spending in the US goes directly towards women’s health.
The drug dose gender gap is one clear example. Research published in 2020 from UC Berkeley and the University of Chicago analyzed data from several thousand medical journal articles and found clear evidence of a drug-dose gender gap for 86 different medications approved by the FDA (including antidepressants, cardiovascular and anti-seizure drugs, and painkillers). The study found that medications are routinely overprescribed to women because the clinical trials were conducted only on cisgender men, and women also experienced worse side effects in 90% of cases. The study also concluded that sex differences in body weight did not explain this “sex difference.” Some 80% of all drugs removed from the US market between 1997 and 2000 were withdrawn because their side effects occurred mainly or exclusively in women. And the trend continued. Between 2004 and 2013, women suffered more than 2 million drug-related adverse events, compared with 1.3 million men in the United States.
Cardiovascular disease is another example – Even in 2015, only about a third of participants in clinical trials for new treatments for cardiovascular disease were female, despite cardiovascular diseases’ being the number one cause of death in American women.
But the list goes on and on. Endometriosis, Alzheimer’s, Crohn’s disease, rheumatoid arthritis, and autoimmune conditions are just a few of the diseases that are affecting women significantly more and receive only a moderate amount of research funding. Researchers examined what would happen if the budget for Alzheimer’s research into women went from $288 million to $576 million. In these simulations, they conservatively assumed that this budgetary increase would deliver just 0.01 percent of health improvements for Alzheimer’s and coronary artery disease, and 0.1 percent for rheumatoid arthritis, over 30 years. But, this is a critical point; even these slivers of improvement produced a shockingly high return on investment. By doubling the NIH budget for research on coronary artery disease in women from its current $20 million, we could expect an ROI of 9,500 percent. Studies focused on rheumatoid arthritis in women receive just $6 million annually. Doubling that would deliver an ROI of 174,000 percent and add $10.5 billion to our economy over the 30-year timespan.
So if these returns are so significant, what’s stopping this research funding increase from happening? Female health-related startups are gaining momentum – and funding – over the past decade. The sheer amount of available health data from both genders will also contribute to a better understanding of the biological differences between how men and women react to drugs, treatments, and aging. In recent years, femtech has evolved from a niche market sector into one predicted to exceed $60 billion worldwide by 2027. The global femtech industry comprises over 200 startups 92% of which are founded and led by women), most of them born out of the frustration around a lack of care for female health issues–from menstrual health to menopause.
I’ve written previously on Femtech as the next big growth opportunity in health care. And I see even bigger things on the horizon. Technology applied intelligently can help narrow the gap in research studies, increase panel sizes, increase the amount of data collected and analyzed, and outcomes reported. The sheer amount of available health data from both genders will also contribute to a better understanding of the biological differences between how men and women react to drugs, treatments, and aging. Improving healthcare outcomes for 50% of the world’s population is a huge business opportunity–and it’s time for the venture industry to start treating it that way. The upside is simply too significant to continue ignoring.