Authors: 

This blog is the output from HealthXLs’ meeting series that explored Digital Women’s Health. Collective inputs from:

Shakti Dookeran (Innovation Lead, Imperial College Health Partners), Elise Dallas (Clinical Lead in Women’s Health Product Team, Babylon Health), Caoimhe Vallely-Gilroy (Head of Digital Health & Therapeutics, Healthcare Business of Merck), Mark Grossman (VP Growth Strategies, GoMo Health), Missy Lavender (CEO, Renalis Health), Jin Lee (Director of Digital Health, Astellas Pharma), Marjorie Gomez (Innovation Consultant, Bayer AG), Robert Milnes (CEO, Fertility Focus), Shailja Dixit (CEO, Curio Digital Therapeutics), Judit Faus (Community Manager, HealthXL), Chandana Fitzgerald (CMO, HealthXL) 

*All opinions are participants’ own and do not reflect the stance of their respective employers. 

Half is not niche

Despite women making up just under 50% ( 49.6%) of the global population, women’s healthcare has been characterised as under-funded and insufficient, with women’s health accounting for only 4% of the overall funding in research and development for healthcare products and services.

Securing early investment in this sector has proven difficult initially for many innovators, with investors struggling to understand the size of the market and assuming it to be ‘niche’. However, the reality is that women control 80% of healthcare decisions (for them and for their loved ones), with women in the workforce spending 29% more per capita on healthcare than their male peers. When we look into the digital health space, women are 75% more likely to use digital tools to track their health, and even when health insurance companies fail them, women are willing to use contraceptive and fertility apps, subscription birth control, and other tools to meet their needs.

Thanks to the rise in digital personalised healthcare and ‘femtech’, the situation has been improving with women’s health technology estimated to have a market potential of $50bn by 2025. Digital women’s health (i.e services, products and software which are created to support women of reproductive and post-reproductive age) presents a valuable opportunity to provide tailored solutions to tackle challenges related to access to health services, awareness of treatment options & support, self-management, participation in research and gender inequalities.

‍

Status Quo: Solutions, Unmet needs and Challenges

The areas that have been more explored so far in digital women’s health are fertility, pregnancy management and contraception. However, women are a multidimensional group that have health needs that go beyond reproduction, and there are a significant number of  unmet needs that are not being properly addressed. There is a huge opportunity for digital health companies to start working on these gaps:

• Management of prevalent women’s conditions like PCOS and endometriosis. Even though these affect millions of women, investments in innovation in these areas are still low.
• Management of diseases that are more prevalent in women or affect women differently such as Multiple Sclerosis, Osteoporosis, Chronic Pain, Cardiovascular diseases do not offer gender specific care.
• Mental health: it is known that hormonal cycles can affect mental health, especially after giving birth, when 10-15% of women have postnatal depression. Mental health also becomes an important problem to tackle in conditions like PCOS or endometriosis and in physiological processes like menopause. 
• Digital health provides an opportunity for better self management, enabling and empowering women to be more in control of their own health and wellbeing. Validated remote monitoring technologies that provide actionable health data that can reduce the need to travel in for hospital appointments which can potentially reduce costs for the healthcare service and provide more convenience for women

Even though there are plenty of opportunities, venture capital being male dominated can cause significant roadblocks for femtech companies due to the lack of understanding of women's health needs. Hence, changing this situation is critical for femtech companies to thrive.

‍How can the industry reverse this situation to start addressing the unmet needs? 

1. Raising awareness of the different conditions in women’s health, destigmatising taboos and myths around it, and digital tools can help with this. Beyond the general population, awareness among investors and reimbursement bodies is also critical so that they can gauge this unexploited market and understand the value of digital women’s health tools. 

2. While education is essential, the creation of femtech accelerators (like the FemTech Lab) & female entrepreneurship programs can help support this change. 

3. And last but not least, the collection and analysis of data on women’s health can be useful to inform policy makers and health systems, so that they can reshape their priorities and make better decisions on resource allocation.

‍All these changes will require action and commitment from a range of agencies such as government, health service providers & commissioners, femtech and healthtech founders, research & academica, service users, pharmaceutical companies, MedTech and voluntary sector. 

Here is the HealthXL’s list of companies working in the digital women’s health space from early stage to mature, across various geographies. To access this and many other lists of digital health companies, log onto the HealthXL platform.

‍‍

Routes to market for Digital Women’s Health companies

Currently, investors are not funding many of the digital women’s health companies at a scale that is desirable. Until we get there, partnerships (e.g with pharma, medtech, employers, etc) will be important enablers for innovators to get enough financing to get their products to market. We explored different kinds of partnerships in our working group:

• Pharma - Innovators partnerships

Compared to other therapeutic areas like cardiovascular diseases or oncology, women’s health has not been well approached by pharma and there have not been any significant partnerships yet.

The reality is that pharma sees more value in other therapeutic areas, hence there is a need for more awareness on women’s health and wellness needs, as well as the viability of products targeted at this market. Women’s health companies can help shift the focus. Digital health solutions do not always fit in pharma's traditional model and can require a shift in their business model. Another reason that explains why we have not seen many successful partnerships yet is the lack of capabilities of pharma to go D2C; if the digital health company wants to go D2C, traditional pharma companies do not usually engage this route to successfully distribute the products.

Hence, it seems pharma is not the ideal partner yet, but it is in a perfect position to become a good route to market in the future, especially for DTx products, as they have a remarkable understanding of regulatory pathways and clinical trials and they already have the network to reach out to healthcare providers to promote the products and drive adoption. 

• Medtech - Innovators partnerships: 

MedTech is in a similar position to pharma, however, they have an advantage: they really understand building medical devices and compliance with regulatory frameworks. So it appears to be a good opportunity for MedTech companies. 

• Employer - Innovators partnerships: 

Employer benefit programs happen to be a good pathway. They are more open to providing tools to their female employees. But even though it is a good route, the digital health company still has to activate either the healthcare provider or the customer (or both), because employers are not allowed to do so. That has proven to be a barrier to scale. 

• Healthcare providers:

One of the implications of going to market through healthcare providers is that you need to make sure the product is solving an identified need and fits seamlessly in the provider’s daily workflow. It also needs to meet required regulatory approvals and demonstrate evidence of improving  health outcomes and service user experience. Even though this route is probably the least explored, it might become an important option in the future.

‍

As we have seen, there are different possible partnerships for digital women’s health companies to gain momentum and make a mark, but what are the factors that determine the best route to market? 

Our consensus as a group is that the following are the most important factors to consider: 

• The problem being addressed (e.g PCOS, endometriosis, fertility, wellness, etc) 
• The geography (e.g US vs. EU).
• The type of digital health product: it determines the regulatory needs, which will affect the best route to market. For example, DTx products may need to go under regulatory pathways to be prescribed, therefore, even though they can still go D2C, they also have to consider the prescriptor, and pharma may be a good partner to reach out to HCPs.
  

Whichever route to market a digital health company takes, deciding it at early stages of the product development is key to ensure the product is being designed to support successful adoption in an apt way. 

‍

The Future of Digital Women’s Health

Due to the historical culture of stigma and taboo around women and a male-dominated venture capital world, digital women’s health is still at the beginning of the journey and there are a number of unmet needs to be addressed. 

For digital women’s health to be impactful, the system needs to come together to reverse the situation through: 1) collecting and using data to identify needs and capture insights to develop targeted solutions; 2) raising awareness and prioritising women’s health and set policies relating to women’s health; 3) creating an enabling and supportive environment for founders of digital women’s health to navigate health systems and better understand market access and adoption requirements; 4) strengthening awareness of women’s health among VCs in the market;; and 5) creating more awareness on the medical benefits of DTx
‍

‍