Good morning, Broadsheet readers! Today's guest essay comes from Fortune senior writer Maria Aspan, who dives into her recent work about how medicine has left women behind. Plus: California Public Employees’ Retirement System's money could soon go toward women-managed funds and Rep. Katie Porter makes a bid for the Senate. Have a great Wednesday.
-Missing medicine. A couple of years ago, my colleague Erika Fry and I started having conversations about a theme that keeps cropping up in our reporting: Why is women’s health so underresearched, underfunded, and underserved?
Women account for more than half of the population and 80% of all health care purchasing decisions. They take more prescription drugs than men do and more often go to the doctor. But despite their market power, for much of history, women have largely been treated like an afterthought or inconvenience—at best—for the $4.3 trillion American health care market. Only 5% of all biopharma R&D spending goes towards female-specific conditions, most of which are cancer-related. (Take out oncology and it drops to 1%.) And for all the buzz about femtech, the numbers aren’t better in the startup ecosystem: In 2021, women’s health accounted for only 5% of all digital health investment in the United States.
At worst, this lack of attention creates deadly consequences for women: Witness America’s horrific maternal mortality rate, the worst of any developed nation, and its heightened toll among Black and Indigenous women. (It’s likely to get even worse in the wake of the Supreme Court decision overturning Roe v. Wade in June: Abortion bans increase maternal death rates, several studies have found.) Or there’s what happens when companies, doctors, and regulators ignore decades of patient complaints, as I covered in this award-winning investigation into the risky—and sometimes fatal—business of breast implants. And over the past couple of years, as Erika and I kept talking about this, even reporting focused on other business topics kept bringing us back to women’s health, and the stunning lack of basic services for very common problems. A case in point: my profile of Instacart CEO Fidji Simo, who’s one of the 10% of U.S. women suffering from endometriosis, and whose experience navigating the health care system eventually led her to start her own clinic specifically focused on women’s health.
A year ago, Erika and I were awarded a grant from the NIHCM Foundation, for a “series of stories that will examine how and why the business of science and medicine left women behind.” We’ve spent the past few months reporting on related projects and, in late December, Fortune published the first feature to come out of that grant: Erika’s beautifully written, exhaustively reported story of a simple medical device, called the Jada System, that could help save 70,000 women from dying of post-pregnancy complications every year.
The Jada saga is a global health story about an invention that could save thousands of lives in countries where few can afford it. It’s a traditional startup story, about a group of young founders who built an “elegant” and “basic” solution to a longstanding, life-threatening problem. (Jessie Becker Alexander, the first CEO of the company that developed the Jada, first teamed up with its inventors when they were undergrads at Cal Poly San Luis Obispo.) And it’s a story about how large pharmaceutical companies—and their investors—value women’s health care.
Or don’t.
As Erika writes:
“It’s believed you can’t make money in women’s health,” says Dr. Elizabeth Garner, chief scientific officer for Ferring, a privately held, 72-year-old Swiss company that’s a leader in the field. Garner and others describe that self-reinforcing notion as a brick wall that entrepreneurs and innovators consistently crash into. Valuations of women’s health companies are depressed because there are few success stories to point to, and there are few success stories because they struggle to get sufficient investor support. And with male investors and executives still far more likely than female ones to be calling the shots, women’s health has been that much more likely to wind up in the industry’s discard pile.
I hope you’ll read Erika’s entire story here, down to its devastating kicker about how many lives the Jada device could save in Uganda—if only the doctors and hospitals there could afford it.
Meanwhile, keep an eye out for future reporting in this series. I’m currently working on a feature about over-the-counter access to birth control—if you have a tip to share about that (or a solution to the access problem), or other ideas about how we should be investigating medicine’s gender gap, please email me at maria.aspan@fortune.com.
Maria Aspan
maria.aspan@fortune.com
@mariaaspan
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