2023 EDITIONFEMTECHNOLOGYSUMMIT REPORTS
A blueprint for transformative change in women’s
health, tackling:

AI & THE GENDER HEALTH GAPFINANCING INNOVATION IN WOMEN'S
HEALTHWOMEN-CENTRIC CANCER CARE
ESG ALIGNMENT ON WOMEN'S HEALTH
REDESIGNING HEALTHCARE WITH
WOMEN IN MIND
ROLE OF THE MEDIA IN WOMEN'S HEALTH
IN COLLABORATION WITH

FemTechnology Summit 2023

2023 FEMTECHNOLOGY SUMMIT

Catalyze change

Connect actors
for long-lasting
partnerships

June 6 and 7, 2023

Solve collective
pain points

Raise awarenessfor women's
healthRoche-Turm (Bau 1), Basel, Switzerland

The 2023 edition of FemTechnology Summit brought together 150
expert innovators in women’s health— clinicians, researchers,
femtech startups, corporates, VCs— to collapse silos and tackle
collective pain-points in women’s health.
The reports that follow are the product of this generosity of spirit
and collective expertise.
We hope these reports serve as both inspiration and a roadmap
for the journey ahead.
The challenges we face are collective, but so too are the solutions.
Before each report we break down how these reports should be
used and how (if the mission resonates) you (yes, you!) cancontribute.
With much gratitude and excitement for the world we can build
together,
OrianaFounder, FemTechnology Summit

IN COLLABORATION WITH

FemTechnology Summit 2023

AI & THE GENDER HEALTH GAP
Researchers found that a state of the art approach to AI
used in hospitals has a 70% success rate in predicting
liver disease from blood tests

They also uncovered a wide gender gap - with 44% of cases
in women missed, compared with 23% cases among men

Questions Tackled:Will AI perpetuate the gender data gap even further? Or
can it accelerate women's health?
Which crucial data sets in women’s health should beprioritised?
By which innovative means might they be collected?
What are the most effective ways to incorporate thesefindings into research, clinical practice and corporate
settings?

IN COLLABORATION WITH

FemTechnology Summit 2023

AI & THE GENDER HEALTH GAP
Featured at AI House in Davos
Panel on Harnessing AI To Bridge The Gender Data HealthGap

How You Can Get Involved:
We are piloting FemTechGuide, which collects quantitativeand qualitative women's health data via a platform that
centralizes best-in class women’s health solutions to match
women with a personalized health solution – creating a
database to provide new data for research and innovation.
If you are a Corporate or Clinician get in touch about
what using FemTechGuide might look like for you.
If you are a Researcher or Startup get in touch about
how your work can be made accessible via
FemTechGuide.
Contact: oriana@femtechnology.org
IN COLLABORATION WITH

The Gender Data Health Gap:
Harnessing AI’s Transformative Powerto Bridge the Gender Health Data Divide
FemTechnology | Women At The Table
November 2023

1

The data we need for women’s healthin the 21st century is missing.
The digital age promises unparalleled advancements in healthcare
through AI, but we stand at a crossroads. As we chart our path forward,
we must confront the glaring void in women’s health data. How can westeer AI’s prodigious capabilities to not only recognize but also
address this deﬁcit? And more crucially, as we’re on the brink of an
AI-driven healthcare revolution, how can we redesign this future to be
inclusive, ensuring women’s health isn’t relegated to the periphery?
The Problem
The foundation of contemporary women’s health data is fractured:● Historical Exclusion: Until 1993, women were not mandatorily included as
subjects in clinical research in the US.1 This startling omission spans
critical areas: prescription drugs, vaccines, cancer research, cardiovascular
health, mental well-being, Alzheimer’s, and more.
● The Impact of Time: Even though women have been included for the last 30
years, there exists a lag of about 17 years from translational research todirect patient care.2 Effectively, this means our actionable data on women’s
health is barely in its adolescence.
● Ongoing Biases: Fast forward to 2023, and a majority of biomedical
research still relies predominantly on male mice,3 perpetuating the cycle ofgender-skewed data.

The Implications
The repercussions are profound:1

Women’s involvement in clinical trials: historical perspective and future implications - PMC
The answer is 17 years, what is the question: understanding time lags in translational research - PMC
3
Twenty years and still counting: including women as participants and studying sex and gender inbiomedical research - PMC
22

● Medicine’s Gender Skew: The diagnostic and treatment paradigms inplace today largely reﬂect male-centric data, leading to potential
misdiagnoses, suboptimal treatments, and inequitable health outcomesfor women.4● AI’s Magnifying Effect: Existing AI models in healthcare are trained onthese limited datasets. The swift adoption and reliance on AI, without
rectifying these foundational gaps, threatens to perpetuate and even
amplify these disparities at an unprecedented scale.
● Global Ramiﬁcations: With 90% of US hospitals marching forward with
AI-centric strategies5, the reverberations of these gaps aren’t just national;
they’re global.6 Part of this problem is structural, some is systemic, all willbe ampliﬁed by the use of AI as we currently practise it.7

What is the Gender Data Health Gap?
The Gender Data Health Gap is the difference in quality andquantity of health data both collected and analyzed between
women and men.

4

Sex bias exists in basic science and translational surgical research
90% of Hospitals Have Artiﬁcial Intelligence Strategies in Place
6
Closing the gender data gap in healthcare | McKinsey
7
Raising awareness of sex and gender bias in artiﬁcial intelligence and health - PMC
5

3

Why does the Gender Data Health Gap matter?
The Gender Data Health Gap (whether conscious or unconscious)
is often a factor perpetuating the disparities that women andmen experience in healthcare provision.
This can result in:● Delays in diagnosis:
Women wait an average of 4 years longer to receive a diagnosis for thesame disease as men.8
Many of the ways in which we diagnose diseases (e.g. ‘cut-off’ values,
symptoms or even the instruments used) are overly reliant on the whitemale model of presenting. This results in women being underdiagnosed for
diseases that are present in both sexes but manifest differently. 9● Not being prescribed the appropriate treatment:
In a cohort study of adults with acute nontraumatic abdominal pain,
women were 13% – 25% less likely to receive opioids in the emergency room
for their pain despite presenting with the same pain scores.10
Conversely, between January 2017 and December 2021, women in England
were 59% more likely to be prescribed benzodiazepines (medication often
used to combat anxiety and insomnia) 11 - better known by the brand namesof Valium, Xanax and Temazepam - than men. In 2020, the FDA mandated
that a “black box warning” be placed on benzodiazepines to inform patientsthat withdrawal from the drugs can be life-threatening.

8

Population-wide analysis of differences in disease progression patterns in men and women | Nature Communications
Females with ADHD: An expert consensus statement taking a lifespan approach providing guidance for the identiﬁcationand treatment of attention-deﬁcit/ hyperactivity disorder in girls and women
10
Gender disparity in analgesic treatment of emergency department patients with acute abdominal pain
11
Hundreds of thousands more women than men prescribed powerful anti-anxiety drugs 'harder to come off than heroin'
94

● Care that is not structured to take differences in account:
In a high volume cancer centre:

9 out of 10 men
Undergoing brachytheraypy forprostate cancer were asked
about their sexual healthvs 1 out of 10 women

Sexual function was
discussed with

89% of men
vs 13% of women

Having brachytherapy forcervical cancer

At their initial radiation therapy
consultation

81% of men

Compared toWith prostate cancer had theirsexual health assessed using apatient-reported outcome tool

0% of
women

Some research has indicated that women athletes are more susceptible tomuscle and tendon injury during ovulation12. Female athletes may also be more
susceptible to having concurrent issues like eating disorders, multiple stressfractures, gastrointestinal issues and mental health concerns. But the approachto these issues (although they are related) is fragmented. An interdisciplinary
approach to these issues is not yet the norm.

12

Injury Incidence Across the Menstrual Cycle in International Footballers

5Which parts of the healthcare ecosystem, and who is
impacted by the Gender Data Health Gap?
The Gender Data Health Gap is embedded in the workﬂow of eachand every stakeholder in the healthcare ecosystem, whether they
are conscious of it or not.

1. Physicians● Have a lack of training on how diseases may present differently inwomen or conditions that only impact women.
41% of UK universities do not have mandatory menopause education on the
curriculum.13 This situation results in: 1 in 3 women between 45 to 54
being given an incorrect diagnosis before ﬁnding out their symptoms are
related to menopause, according to a study that also revealed 32% of
women feeling their doctor was not very knowledgeable about the topic14.
● Structural bias in diagnostic tools.
○ Heart Attack:■ Cardiac troponin (cTn) test: Is used to measure the level of troponin(protein released by damaged heart muscle) in the blood. Higher
levels of troponin are used as an evaluation parameter for more heartdamage. The clinical threshold that signals a heart attack can differ
between men and women, i.e. a woman could be having a heart
attack but the troponin level would be below the level of detection.
■ Cardiac catheterization: is used to detect blockages in large arteries.
Women are more likely than men to have plaque buildup in thesmallest arteries due to inﬂammation, which could be better
visualized with an MRI.
If the tools used for screening for heart attacks render ‘invisible’ the heart
attacks women have, this can further contribute to misconceptions about
what type of individual has a heart attack. This is a part of a reason (but not
the only one) that women have a 50% greater chance of misdiagnosis of aheart attack compared to men.

13
14

Menopause knowledge and education in women under 40: Results from an online survey - PMC
Nearly 1 in 3 Women Have Had Their Menopause Symptoms Misdiagnosed

6● Lack of treatment options to prescribe to patients.
There are only 2 FDA-approved treatments for female sexual dysfunction which impacts approximately 40% of women in the world - vs 27 treatment
options for men.15
The ﬁrst treatment option for sexual dysfunction for women was only
approved in 2015 vs men’s treatment options beginning in 1998.
Furthermore, research investigating the interaction between alcohol andAddyi, one of the drugs developed for treating female sexual dysfunction,
included 23 male participants and only 2 female participants.
● Patient dismissal.
Variability in national regulatory decision:
Medicalabortion pill

Oral contraceptive pill(birth control)

Sildenaﬁl (“viagra”) for
erectile disfunction

Time for approval by
USA FDA:Time for approval by
Ministry of Health, Japan:

Time for approval,
Japan & USA

4 years

35 years

6 months

84% of womenreport feeling dismissedby their GP in the UK.16

Nearly 1 in 4 women
say they do not feel their clinician
takes their pain seriously(versus 1 in 6 men). 17

2. Physicians● Lack of awareness around female-centric diseases, which are diseases
that disproportionately impact women or diseases that present differently
in women result in:○ Delays in diagnosis (from the patient side) as women are not awarethat they should seek care, or that care is indeed available.
15

A discussion about treatment options for women's sexual dysfunction
Results of the ‘Women’s Health – Let’s talk about it’ survey - GOV.UK
17
See My Pain | Nurofen
16

7

An incomplete picture of potential complications of the condition. For
example, the link between PCOS (Polycystic Ovary Syndrome), which impacts anestimated 8-13% of reproductive aged women and cardiovascular disease studies
suggest that women with PCOS have 2x risk of a future cardiovascular event, suchas a heart attack or stroke.

3. Researchers● Lack of sex disaggregated data.
In COVID-19 vaccine trials, 28.3% of publications did not report sex
distribution among participants. Only 8.8% of the studies provided sexdisaggregated Vaccine Effectiveness estimates.18
Sex-disaggregated data is essential to understand whether there are
increased side-effects in one sex or the other, and more generally to
18

Sex-disaggregated effectiveness data reporting in COVID-19 vaccine research: a systematic review - PMC

8

understand the distributions of risk, infection and disease in the
population. For example, a study that looks at the impact of a new drug on
pain relief might draw the overall conclusion that a drug is effective forboth men and women.
Disaggregation would allow visibility into whether the drug works
better in one sex than the other, as women and men may well have different
mechanisms for experiencing pain19. Data disaggregated by sex also allows
better visibility into how resources are allocated.
● Non-representative numbers of females and males in studies.
A 2010 survey examining 2000 animal studies found that 80%
included more males than females. As recently as 2016, 70% of biomedical
experiments did not include sex as a biological variable, and of those that
did include sex as a biological variable less than half of them included bothmales and females in their trials.
Women’s participation in clinical trials remains low, especially inphase I trials (around 22%). Pregnant and lactating women continue to be
excluded from clinical trials – even in postmarket phases. This lack ofevidence poses challenges for physicians when advising pregnant andbreastfeeding women in need of medical treatment.20-

Meaningful representation and analysis of outcomes by sex when it
comes to clinical trials still falls short – for instance, the approval of
emtricitabine/tenofovir alafenamide (Descovy) for HIV pre-exposure
prophylaxis in the United States in 2019 was limited to men andtransgender women, excluding individuals assigned female at birth. The
manufacturer cited difﬁculties in recruitment, resource constraints, anduncertain expectations of achieving signiﬁcant clinical outcomes as thereasons for this exclusion.

Current guidelines suggest that women should be included in trials
in proportion to their prevalence in speciﬁc health conditions, but thistarget is not met in serious disease areas like cardiovascular conditions
and certain cancers. Out of the 40 medicines approved by the FDA in 2019
for conditions affecting both sexes, 16 had less than 50% representation of
women.

19
20

Why the sexes don’t feel pain the same way
Gender bias in research: how does it affect evidence based medicine? - PMC

9-

Focusing solely on prevalence fails to address sex differences in diseaseprogression or mortality. For example, in the case of erdaﬁtinib, which
the FDA approved for a type of bladder cancer in 2019, only 21% of theparticipants were women. The justiﬁcation for this skewed ratio wasthat men were affected at a signiﬁcantly higher rate, even though
women had poorer prognostic and survival outcomes, even withalternative treatments.

● Not having visibility into where the gaps in women’s health researchexist
As an example, the NIH has not assigned a unique identiﬁer code tomenopause, unlike other conditions such as anorexia or prostate cancer.
This means that anyone who wants to know how much funding the NIH hasawarded for research on menopause must manually count the number ofgrants that mention “menopause” in their titles or descriptions.

4. FemTech Startups● Gender Data Health Gap
Lack of consistent data surrounding prevalence, incidence, economic andquality of life burden of diseases in women’s health impacts the ability of many
FemTech Startups to craft more traditionally compelling businesses-cases.
Without data the problem is often dismissed as too ‘niche’ or ‘small’ to offer
solutions for their populations.
Lack of data also poses a problem from an investment perspective. It makes it
difﬁcult for startups to objectively quantify the speciﬁc problem they are solving,forced to rely instead on more general metrics such as the size of the ‘FemTech’sector as a whole.
Furthermore, data often acts as a substitute for lived experience - which, in the
FemTech sector, is vital, as those in decision making positions often have notexperienced the problem themselves. For example, startups that tackle fertility
and cancer treatment within FemTech are the ones that routinely raise the mostmoney (these are also areas that male founders in FemTech are more involved in).
70% of femtech startups are founded by women, yet male-founded startups
raise more capital. On average, female-founded femtech startups raise $4.6m,
compared to $9.2m by those with all-male teams.21
FemTech startups thus face an uphill battle, having to convince
stakeholders of the need for their solution in the ﬁrst place. If they are21

https://sifted.eu/articles/even-in-femtech-it-still-pays-to-be-a-male-founder10

successful in convincing stakeholders of the need and market opportunity for
their solution, they are then confronted by the challenge of a lack of pre-existingdata sets from which to base their solutions. It is difﬁcult to develop diagnostic
and/or therapeutic solutions for women’s health conditions when much of thefoundational data and basic translational science in the ﬁeld has not yet been
carried out.
As an example, we still have a fundamental lack of research and understandingof the pathophysiology of many ‘common’ women’s health conditions such as
Endometriosis (which impacts approx. 1 in 10 women, Uterine ﬁbroids (which up to
77% of women during childbearing years experience), PCOS (which 1 in 10 womenexperience) or PMDD (which impacts between 1-12 and 1 in 20 women ofchildbearing age). Subsequently, all of the aforementioned conditions rely on
imprecise diagnostic tools and none possess a cure.
● Novel ways to collect data sets to tackle the Gender Data Health Gap inreal time
As we have noted, women’s health is rife with information that has not been
researched and data that have not yet been collected. FemTech start ups are
uniquely poised to disrupt this by collecting novel women’s health data sets inreal time.
● Patient Reported Outcomes
What is it that women want to know about their own health? Where
are they looking for answers and consistently not ﬁnding solutions? How
can we prioritise the problems women themselves want to be solved inorder to identify the most pressing ‘unmet needs’.
-Roche’s #MyStoryForChange initiative: The stories of 600 womenacross the globe were collected to better understand the interaction
bias women experience with the medical system. A theme thatemerged in healthcare settings is that many women feel as if they
are not being listened to or that their experiences are not being taken
seriously.
There is a need to ﬁnd alternative ways to access the healthcare

experiences of women, to really learn what issues women are struggling
with. We need qualitative as well as quantitative data.
-

Clue, the #1 doctor-recommended free period tracker app built incollaboration with top health researchers, is a good case study in thevirtuous cycle of women being able to use their own data to advocate
11for themselves. In the words of Audrey Tsang, Co-Ceo, Clue: “We often
hear users in our community say that ‘I just want to be taken
seriously’. The world today doesn’t take their pain or their concernsthat ‘something doesn’t feel right’ seriously. That’s why they track in
Clue—so that their data can help them advocate for themselves andthe care they need”● Reimagining care
Women are more likely to suffer from chronic conditions yet ourcurrent healthcare model is structured to service acute situations (and is
episodic in how it engages patients).
If we employ a more consistent, longitudinal means of engaging
patients that would expand the type of information we are able to collect.
For example, noticing patterns in depressive episodes that might be linked
to hormonal ﬂuctuations.
● Collecting novel biomarkers and datasets via FemTech Startups:
FemTech startups are uniquely poised to collect data sets that havebeen previously neglected. Some participants in the 2023 FemTechnology
Gender Data Health Gap Workshop doing this are:
○ Impli: Continuous hormone monitoring via an implantable device,
which has the potential to assist fertility specialists in selecting thebest treatment by understanding the patient's hormonal proﬁle, or
improve chances of successful fertilization and implantation by
optimizing medication dosages and timing.
○ Daye: At-home vaginal microbiome screening, using a diagnostic
tampon to check for infection-causing microbes and fungi, as well as
levels of protective, good bacteria.
○ TheBlood: Analyzing menstrual blood for unique biomarkers in women’s
health via an at home blood analysis kit for menstrual blood.
○ Sanno: Supporting patients with chronic conditions in gut andmetabolic health, immunology and women’s health to connect themwith clinical trials in the space.

12

The gender data gap is turbocharged by AI
In the context of continuing and widespread AI adoption in healthcare, we
run the serious risk of structurally embedding biases and gaps. Without being
aware. Again.
AI learns from the data it’s trained on therefore if women are ‘invisible’ ormisrepresented in that data, this can have lethal consequences.

Gender bias revealed in AI tools screening for liver disease22.

What is algorithmic bias in a healthcare context?
Deﬁned for the ﬁrst time in 2019 in the Journal of Global Health as “theinstances when the application of an algorithm compounds existing inequities insocioeconomic status, race, ethnic background, religion, gender, disability orsexual orientation to amplify them and adversely impact inequities in healthsystems.”23
We are becoming more and more aware of how this nexus of missing data
sets and our speed in deploying AI models with missing data will entrenchinequities.

22
23

Gender bias revealed in AI tools screening for liver disease | UCL News - UCL – University College London
Artiﬁcial intelligence and algorithmic bias: implications for health systems - PMC

13

How does bias enter into AI in health research?
Table: Examples of Types of Bias in Artiﬁcial Intelligence & their descriptions24
Type of Bias

Description

Inherent or
Historical Bias

Even when data is accurately collected and sampled, models
might yield undesired results due to pre-existing societal
biases in the world.
e.g. making the mistake of associating HIV primarily with gay andbisexual men because of its higher occurrence in this group.

Representation or
Sampling Bias

When certain segments of the data input are not adequately
represented.
e.g. a large part of genomics research predominantly focuses on
European male demographics, sidelining other ethnic groups.

Data Proxy Bias

When the data we collect serves as an indirect measure for thedesired attributes.
e.g. using various clinical, social, and cognitive indicators to identify
early stages of schizophrenia, even though gender differences caninﬂuence the manifestation of these indicators and their related
psychosis risk.

Generalization /Aggregation Bias

When a universal model is applied to groups that havedistinct underlying conditions.
e.g. despite diabetes’ variable interpretations across different
ethnicities and sexes. the widespread use of haemoglobin A1c (HbA1c)
levels to diagnose and track the disease.

Evaluation or
Benchmarking Bias

when the data used to test or benchmark an algorithm isn't agood match for the intended audience.
e.g. the underwhelming performance of certain facial recognition
technologies on individuals with darker skin tones, especiallyfemales, because most benchmark images are sourced from whitemales.

Modelling Bias

Bias can be inadvertently or deliberately embedded into analgorithm, especially when relying on improvised solutions.
e.g., when a commercial health prediction algorithm used healthcare
costs as an indicator for health condition without factoring inprevalent disparities in healthcare accessibility, it displayedconsiderable racial prejudice changing predictions of genuine need.

24

Sex and gender differences and biases in artiﬁcial intelligence for biomedicine and healthcare - PMC

14

Synthetic Data
As we wait to collect the much needed missing data sets on women’s healththere is a discussion about the use of synthetic data to augment data sets. Thisis a very promising approach on a number of levels but which has its own
limitations if not thought through carefully.
Before using synthetic data to add to a dataset it must be noted that many
patient cohorts had minimal participation in the original data.25 Statistics showthat racial and ethnic minorities comprise 39% of the United States
population but only account for 2% to 16% of clinical trial participants.
Factors

like

age,

biologicalsex, disabilities, chronic comorbidities,

geographical location, gender identity, race, and ethnic background may inﬂuence
how an individual reacts to a certain drug, medical device, or treatment plan. If
patients in clinical trials do not represent the whole community, there is the riskthat differences in drug metabolism, side effect proﬁles, and outcomes will bemissed.
This also translates when using synthetic data. The lack of diversity insynthetic patient cohorts can result in AI models that perform poorly on real-world
populations. As an example, generating data for 500 Black male patients and 500
Black female patients using a synthetic data generator trained on predominantly
white medical records would not accurately reﬂect the true disease progression
and outcomes experienced by Black patients.
To address this, representative real-world data must be collected ﬁrst toensure that AI models do not perpetuate healthcare disparities. Moreover, thesynthetic data landscape in healthcare is fraught with ethical considerations.
While synthetic data offers the potential to accelerate medical research, drug
development, and personalized treatment strategies, it must be used with care to
avoid reinforcing biases and ensuring patient privacy and consent.
The opportunities for bias to enter into the data and machine learning
lifecycle occur at every stage from inception, to System Requirement deﬁnition,
data discovery, selecting and developing a model, testing and interpretingoutcomes, and post-deployment/ Impact & Audit.

25

https://aiequalitytoolbox.com/library/synthetic-data/15

A multifaceted approach
Addressing gender data gaps in healthcare using AI requires a multifaceted
approach, both in terms of technical solutions and systemic awareness. Here aresome thoughts on a multi-dimensional strategy to ﬁll these gaps, keeping thedata limitations in mind:● Acknowledge the Limitations: First and foremost, any AI solution should
clearly communicate the limitations of the data it's trained on. Users should beaware that predictions or insights may have inherent biases and are not likely
to be as accurate for underrepresented groups, particularly women.
● Collaborate with Experts: Collaborate with gender researchers, sociologists,and clinicians who have expertise in women's health. Their insights can guidedata collection, feature engineering, and model evaluation.
● Crowdsource & Citizen Science: Engage the public, especially women, incollecting and contributing health data, including with wearables. Initiatives
like Apple's Research Kit have shown how valuable citizen-contributed data
can be for medical research.
● Synthetic

Data

Augmentation:

Using

synthetic

data

augmentation

techniques to artiﬁcially increase the size of underrepresented datasets. As
noted above, this doesn't replace real data, but it can help improve model
performance by generating synthetic data based on existing patterns. With
important caveats as ‘existing patterns’ can translate into perpetuating
healthcare inequalities.
● Transfer Learning: Use models pre-trained on related tasks or datasets to
beneﬁt from their learned features. This can be particularly helpful if there are
related areas of medicine where more diverse data is available.
● Meta-analysis and Data Synthesis: Conduct a meta-analysis of existingstudies to derive broader insights. Even if individual studies are male-centric,
combining results could help highlight patterns or trends that are relevant towomen.

16

● Inclusive Model Development: Design models that explicitly account forgender and other demographic differences. For example, use multi-task
learning where one task could be predicting a medical outcome, and anothertask could be predicting gender, making the model aware of genderdifferences.
● Regular Model Evaluation and Audit: Continuously evaluate and update themodels as new data becomes available. This iterative approach ensures that
AI solutions improve over time and remain relevant. If models ‘go rogue’ inthe wild, retire them.
● Ethical Oversight: Establish an ethics committee or review board focused on
AI in healthcare. This board can assess AI solutions for potential biases,
ensuring that they meet ethical and inclusivity standards.
● Feedback Mechanisms: Implement feedback loops where clinicians andpatients can provide input on AI predictions or insights. Over time, this canhelp in reﬁning the model and making it more attuned to real-world nuances.
● Education and Training: Educate healthcare professionals on the limitationsof AI tools, especially when they're based on historically biased data. This
education ensures that they can make informed decisions and remain criticalof AI outputs.
● Push for Policy Change: Advocate for policies that ensure more inclusive anddiverse data collection in future clinical trials and studies. Over time, this will
help in reducing the data gaps.
By embracing these strategies, AI can be a powerful tool to ﬁll the data gaps inwomen's healthcare, while also ensuring that the solutions remain transparent,
ethical, and continuously improve.
“If used carefully, this technology could improve performance in healthcare and potentially reduce inequities,” says MIT Assistant Professor Marzyeh
Ghassemi. “But if we’re not actually careful, technology could worsen care.”26 27
26
27

The downside of machine learning in health care | MIT News | Massachusetts Institute of Technology
In medicine, how do we machine learn anything real?: Patterns

17FemTechnology Summit 2023

FINANCING INNOVATION IN
WOMEN'S HEALTH
The current funding patterns neglect Female Health Conditions
with only 4% of US healthcare R&D spending going directly tofemale health of which only 1% goes fordiseases outside of oncology$$$

if we invest$300 MILLION
in women's health across just
3 diseases, we get$13 billion

in returns to our economy

2x more funding

male prevalent diseases
vs female prevalent diseases

Questionst tackled:
What strategies can be put in place to share the burdenof development for novel innovative medicines inwomen’s health?
How can multi-stakeholders come together and clearly
outline hurdles to build new workable paths andinnovate on endpoints in underserved women’s healthconditions such as endometriosis, PCOS and fibroids?
IN COLLABORATION WITH

Visit our Website

FINANCING INNOVATION IN
WOMEN’S HEALTHA PATH TO ADDRESSING DISPARITIESAND ACCELERATING INNOVATIONNOVEMBER 2023

This paper explores the challenges and opportunities in financing innovation in
Women’s Health. Despite significant unmet medical needs in female-associateddiseases, funding research and development (R&D) in this area have been historicallylimited. To foster innovation, this paper proposes a comprehensive approach, including
policy making, public investment, and collaborative efforts, inspired by successfulmodels in other fields such as orphan drug development.

Disclaimer: Women’s Health is a general term used to describe indications and diseases that affect uniquely, differently
or disproportionally people with uteri, who may or may not identify as women.

NOVEMBER 2023

Visit our Website

FINANCING INNOVATION IN WOMEN’S HEALTH

1. Context
Women’s Health encompasses a broad spectrum of diseases and conditions that may either:01

be exclusive to females,02

be more prevalent in females or03

impact females differently and/or disproportionately;

The exact boundaries of this definition remain somewhat ambiguous, allowing for the inclusionof diverse medical indications and terms. Despite the significant unmet medical needs within thisfield, Women’s Health (defined as above) has not received the attention obviously warranted interms of research funding, for instance, accounting for only 10.8% of NIH funding³. Similarly, thebiopharma industry has invested merely 4% of its resources, with the majority being directed
towards cancer research¹. Recognizing these critical shortcomings, and drawing parallels withother therapeutic areas, that produced innovative drugs that addressed significant unmet needs
and also achieved commercial success is crucial.
To discuss an actionable roadmap forward, catalyze change and raise awareness for the
Women’s Health field, stakeholders spanning various sectors of the R&D value chain (including
researchers, biotechs, pharmaceutical industry, and investors) convened on June 7, 2023 at
the FemTechnology Summit in Basel, Switzerland. This paper presents the outcome of those
deliberations as well as further discussions with Key Opinion Leaders, and outlines the proposed
strategies for advancing research and development in Women’s Health.

PAGE 3/19

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2. Current status of Funding Innovation in Women’s Health
How relevant is the definition of Women’s Health to Leverage Biomarkers in Drug
Development?
Properly defining Women’s Health can be a complex task.
While reproductive system-associated diseases
have been the obvious indications used todefine Women’s Health (e.g., female
infertility,

Endometriosis,

Polycystic

Ovarian Syndrome) to date, the field“The lack of funding in women’s health is why, even

now agrees that a true definition of

today, we still don’t have answers about so much of the

Women’s Health should expand

basic physiology of 50% of the world’s population. For
example, did you know that there are approximately

to indications more prevalent in

400 studies on menstrual effluent compared withfemales (e.g., Multiple Sclerosis,

15’000 studies on semen? Or that in 2020, only 10.7%of the basic scientific research funding provided by

Alzheimer Disease). Nevertheless,the United States government went towards women’s

there exists a substantially bigger

health research? The lack of funding in women’s healthset of indications that can be

has dire real-world consequences. If stories form abackbone for our society — how can we weave stories

categorized under the Women’sthat incentivise – no, demands — innovation in women’s

Health umbrella. In essence, any

health? It requires a movement — and that movement

condition in which women exhibit

starts with us.”distinct symptoms and responses could
be considered within the realm of Women’s
Health, including diabetes and cardiovasculardiseases, for example, which would in turn open
a whole new perspective on possible disease/sex-

Oriana Kraft
Founder, FemTechnology

specific biomarkers.
In recent years, the field of personalized medicine and drug development has boomed, leading
to higher Probability of Success (PoS) and blockbuster drugs. While identifying biomarkers canpose challenges, in this context, the most evident biomarker is biological sex. Quoting Dr. Marcus
Altfeld, an immunologist at the Heinrich Pette Institute in Hamburg, Germany, “Everyone isspeaking about personalized medicine, having personalized
approaches for every individual (…),
I think having a step before there, maybe stratifying the population into male and female, and

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optimizing treatment strategies there, is an important step.”⁷.
By recognizing the significance of biological sex as a logicalbiomarker in drug development, we can pave the way for
tailored therapies that cater to the specific needs offemale (and male) patients, ultimately leading tohigher treatment efficacy and a greater PoS for
drug developers. This approach also opens up

The opportunities that exist to improve

the possibility of repurposing and tapping into

therapeutic solutions for women and theirpreviously unexplored diseases, as many drugs

economic impact are enormous. Replacing ordelaying e.g. laparoscopies and hysterectomies

may have potential when tested separately inwith targeted non hormonal pharmaceuticalboth sexes.

treatments for endometriosis can lead to anincrease of the quality of life of patients withendometriosis and a reduction of the current

Roots of Disparity: Funding and R&D Challenges

disease burden significantly.

Women’s

Healthhasbeenhistoricallyunderfunded¹,³ which has hindered innovation greatly
both in diagnosis and treatment. This critical imbalance
persists despite the widespread prevalence of conditions
such as endometriosis, which afflicts an

Liliane Brunnerastonishing 10% of females worldwide, andHalbach Artemis Women’s Health Foundation

represents a pressing need for more effective

Deputy Head Therapy Development Accelerator at thediagnostic and treatment options⁶.

University of Zurich

A stark disparity becomes evident when comparing Women’s Health to other therapeutic areas
within the biopharmaceutical industry. The market is dominated by generics, primarily hormonetargeting drugs, leading to fierce pricing competition. Additionally, regulatory guidance from
FDA and EMA on several of these conditions remains conspicuously absent contributing to
the already high R&D hurdles for clinical trial sponsors (e.g., lack of clinical trial endpoints,
low recruitment rates, inadequate animal models). Furthermore, there is a profound lack ofcomprehension surrounding the underlying pathophysiology of these diseases, a deficiency inbasic research that significantly constrains the development of novel mechanisms of action and/or bringing innovative treatments from other therapeutic areas into Women’s Health.
Nevertheless, there is a growing number of initiatives aimed at supporting early-stage innovative
developments. One example of a funding model that encourages transformative research is
the BioInnovation Institute (BII). BII provides financial support for innovations that propel the
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creation of novel solutions, particularly by early-stage life science start-ups operating in diverse
areas, including Women’s Health. Another example is Repro Grants, which is a program thatawards grants to scientists or academic institutions dedicated to the advancement of Women’s
Health research. While these initiatives undeniably play a pivotal role in propelling early-stage
research aimed at unraveling the underlying pathophysiology of diseases, it is imperative toacknowledge that realizing substantial progress in this field will necessitate significantly larger
investments.

3. Way forward to Financing Innovation in Women’s HealthIrrespective of the therapeutic area, to increase interest ofinvestors, pharmaceutical industry and other stakeholders,a positive business case needs to be established. In thecontext of Women’s Health, which impacts over halfof the global population, it is crucial to articulate bothInvestment in women’s healththe broader economic rationale at the government

will accelerate the transformationlevel and the more focused investment perspectiveof dreams into innovation reality.

relevant to private investors with shorter timeframes.
At the governmental level, the 2021 WHAM report
already demonstrated that funding Women’s Healthresearch can have a great economic impact (investing $300
million can save $13 billion to the US economy in the next 13
to 25 years)². Regarding private

Kathrin Schoenborn

investors, one could also argue

Advisor | Business Angel | Non-executive Director | Diversity enthusiastthat the current model of Venture
Capital investment in biopharma may not be adapted to the field of Women’s Healthsince VC incentives focus on the “sprint” commercialization, rather than the “marathon”
of creating value and change. Changing such dynamic is a much broader Therapeutic
Area-agnostic endeavor.
In the current financing setup, when economic incentives for biopharma are lacking, it becomes
necessary to establish new ones. There are two main paths to create such incentives. One possible
path is to launch a Women’s Health moonshot initiative with substantial grants for both basic and

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clinical research, including sex-specific biomarker discovery thus de-risking private investment.
However, in the absence of such substantial investment, the foundational step should involve
Policy Making & Regulatory support. In Figure 1, we present this potential pathway to achievefinancing innovation in Women’s Health. Once a foundation of Policy Making & Regulatory
Support and/or sufficient Public investment is in place, the next step is to build a solid foundationof basic research. Thorough preclinical studies are essential, allowing us to better understandpathophysiology, a vital component on our journey toward financing innovation. Clinical Proofof Concept (PoC) takes the stage next (Step 4). This phase relies on research partnerships andthe generation of clinical PoC data by biopharma to create compelling value propositions (Step5) that can attract the investment needed to drive innovation in Women’s Health (Step 6). It is
important to recognize that this journey towards financing innovation in Women’s Health will

Clinical Validation
Research partnerships &clinical PoC data creation by
Public Investment
Moonshotbiopharma

Financinginnovation in Women’s Health6

Into Women’s Health space
through research grants and4

sex-specific databases.

2
1

5
3
Value Creation
Creation of intriguing value

Policy Making & Regulatory

propositions that attract investment

SupportIncreases awareness, and economic
incentives for Women’s Health

Basic Research
To understand in depth the pathophysiology throughthorough preclinical research

Figure 1 | Achieving the goal of financing innovation in Women’s Health starting from a moonshot investment inresearch or, in the absence of it, from effective policy making & regulatory support. Source: Catenion

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not be a swift one, as basic research,
for example, cannot yield immediate results and requires

significant time and effort – a reality that may currently pose challenges to venture capital
timelines that prioritize rapid PoC and quick exits.

4. Drawing Parallels with Orphan Drug Development:
Women’s Health would not be the first example of policy making and regulatory change driving
innovation. Historically, orphan diseases were an area in which for many years biotechnology andpharmaceutical companies refrained from developing drugs due to low expected commercial
returns. This changed upon the efforts of patient organizations that led to the Orphan Drug
Act (Figure 2)⁴,⁵. Learning from the success of the Orphan Drug Act, which transformed raredisease research, we can apply similar principles to Women’s Health. Policy makers, regulators,

1970s
10 drugs fororphan diseases

Now

1980

1983

1993

2000 2002

2015

Active work by>500 drugs
for orphan
diseasesmarketed

the National
Organization for

RARE-X

Rare Disorders(NORD)

21st Century Cures
PolicyPolicyAct and the Orphan

Orphan Drug Act (ODA)

10 yearsMarket exclusivity

Product Extension

7‐year market exclusivity for

exclusivity,of 10 years

Now Acceleratingorphan drugs

Reimbursement of

Accelerated

Cures and Treatment

Tax credits for certain R&D

up to 50% of R&D

Approval

Act of 2015

costs

costs, plus 6% tax

Financial support

Federal and state grants

credit,for R&D varies

Fast‐track approval

Accelerated

across country

Waivers of PDUFA fees

approval

Grants

Policies

Patient-led

marketed

2019

Rare as One Network: Backs 30 grantee
patient organizations that are taking
on activities usually left to venture‐

Grant Program

backed biotech (pharma partnership

Rare Disease Act of 2002

development, launching and maintaining(Founding Rare Diseases

clinical registries, building biobanks andClinical Researchtissue repositories, starting clinical trials

Network - NIH)

Figure 2 | Orphan Drugs: From empty pipelines to >500 drugs marketed. Sources: Catenion analysis; FDA.gov; NORD
“Impact of the Orphan Drug Tax Credit on treatments for rare diseases” 2015

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patient organizations, and public funding agencies played a pivotal role in incentivizing drug
development for rare diseases. A positive business case was created by addressing pricing
issues, encouraging investment, and improving patient access. Similarly, for Women’s Health,a collaborative effort is necessary to encourage investment and research to initiate the steps
towards investment in the field.
The same is true for other fields such as Pediatrics, in which there are clear differences in responses
to drugs between children and adults, including different dosages and unique pediatric adverse
events. Therefore the Best Pharmaceuticals for Children Act (BPCA) in 2002 and the PediatricResearch Equity Act (PREA) in 2003, driven by the United States Congress, were establishedfor similar reasons that we observe for females today: safety and effectiveness differences(out of the 668 drugs used for the 20 most frequent treatment regimens in the US, 86 show
significant sex differences in pharmacokinetics in females⁸). Even cases that are also far frombeing addressed, such as Racial and Ethical Representation in clinical trials, had legislative actsby the FDA (FDA Amendments Act of 2007 (FDAAA), Prescription Drug User Fee Act (PDUFA)
2016, 2021 FDA’s guidance on Enhancing the Diversity of Clinical Trial Populations) in orderto encourage development of drugs that address health disparities. These health disparities
are also true for females who are underrepresented in preclinical studies & clinical trials. (e.g.,
Cardiovascular Diseases are the #1 reason of death in females, but in clinical trials, only a quarterof participants are females⁹).

5. Policy Making for Women’s Health Innovation:
Given the importance of policy making to drive innovation forward and increase financial
incentives to the Women’s Health field, Catenion discussed the current state of the Women’s
Health with 3 experts from United States (US) and 2 from Europe (EU) (policy maker experts
from EU and US, and pharmaceutical, medical device and regulatory experts from the EMA and
FDA).
Across the spectrum of experts, a consensus emerges highlighting low awareness and limited
interest in the Women’s Health arena. However, there are differences in sentiment whencontemplating the trajectory of this field over the next 5 to 10 years. While a majority of experts
exhibit optimism by anticipating the formulation and implementation of policies aimed at
fostering innovation in Women’s Health within the next 5 years, and quite possibly extending
into the subsequent decade, it is worth noting that some remain cautiously skeptical about the

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likelihood of substantial transformation during this period. All experts concur that ongoing
discussions about reproductive rights have heightened interest in Women’s Health as a field.
However, the challenge of expanding beyond this narrow definition of Women’s Health remains
substantial. Notably, some experts believe that as a new generation of policymakers assumes
positions of influence and leadership teams in regulatory bodies undergo changes, their uniqueexperiences and insights into the healthcare system will bring about different expectations andcatalyze change within the field.
Education of the General Public and Policy Makers is Vital to Raise Awareness and Interest
in innovation for Women’s Health
Women’s Health currently receives insufficient recognition from both policymakers andregulators. This is evident in the inadequate funding allocated to researchers and entrepreneursin the field, resulting in a limited understanding of the underlying pathophysiological processesof related diseases. As elaborated earlier, there’s a pressing need for increased incentives on theregulatory front, similar to those granted to orphan diseases. While the FDA and EMA review
and approve novel pharmaceuticals and medical devices, these agencies function solely as
regulatory bodies, adhering to decisions made by healthcare policymakers (the US congress
and the European Commission, respectively). Although they consult policy making, they lackthe autonomy to offer incentives independently. Therefore, it becomes imperative to raise
policymakers’ awareness about the current state of Women’s Health and the areas that require
enhancement.
One of the primary policy challenges encountered is the lack of a comprehensive understandingof Women’s Health. Today, many policymakers and policies in this domain narrowly focus on
reproductive health. As voiced by an interviewed US policymaking expert, “…the important
thing is going to be trying to point out that there’s a lot more to Women’s Health… All their[policymakers’] focus is on access to abortion and domestic violence and that’s it. There is more to
Women’s Health than just pregnancy. There’s a way to leverage concern over reproductive health.
But to point out that reproductive health is just a small part of the unique needs of women.”.
To alter this narrative effectively, establishing a solid business case for Women’s Health is critical.
This entails identifying all needs, including but not limited to reproductive health, quantifying
their impact on healthcare costs, and showcasing how resolving these issues can lead to longterm healthcare cost savings. Only then advocating rooted in data for policy changes can be

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done. In recent years there have been noticeable shifts in the field. In addition to WHAM’s
efforts to highlight the economic aspects of investing in Women’s Health, ongoing initiatives
led by the NHS Confederation in England are working on a report to highlight the business caseof investing in Women’s Health. This report will quantify the intrinsic links between investment
in women’s health and wider economic growth to make the case to the UK government thatwomen’s health, the NHS, and the wider economy cannot continue to be viewed as separate
concerns, and the most basic needs of 51% of the population should be prioritized.
The Pivotal Role of Patient Advocacy Groups in Shaping Policy
Experts unanimously affirmed the pivotal role of effective
policymaking in driving incentives within the Women’s
Health field. To engage policymakers effectively,
experts stressed the significance of leveraging
patient advocacy groups and the influencethese groups can exert. To ensure productive

Empowering women’s healthdiscussions with tangible outcomes, it is vital toinnovation is not just a choice; it’s

approach policymakers with specific indicationsa responsibility we all share. Let’s
invest in a healthier and equalthat exhibit high unmet medical needs, rather

future.

than approaching Women’s Health as an entity.
Supporting these discussions with patient stories
and empirical data, demonstrating unmet medical
needs and the economic benefits of improving current

Cristina Vilarmau
Innovation Manager at MiMARK

treatment options is imperative. For instance, highlighting theneeds of the growing number of women entering menopause with limited options to enhancetheir quality of life, which can result in prolonged participation in the workforce. A recent
study by Mayo Clinic supported this by showcasing that menopausal symptoms costs American
women an estimated $1.8 billion in lost working time per year¹⁰.
Leveraging
Established Consortia to Enhance Credibility,
While patient advocacy groups provide essential real-world examples of the impact of diseases

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on individuals, they require scientific validation from the industry. To accomplish this effectively,
experts emphasize the importance of establishing consortia that bring together researchers,
drug developers, and physicians to address critical gaps and define objectives aimed at
resolving these issues. Given that approximately 80% of healthcare professionals in the US &EU are female¹¹,¹², it is reasonable to assume that the industry would be keen to form suchconsortia. While newly formed consortia, particularly those focused on specific Women’s Healthindications, are crucial in the field, enhancing the credibility of discussions with policymakers
may necessitate engaging with more established consortia such as The American College ofObstetricians and Gynecologists (ACOG) or The European Board & College Of Obstetrics And
Gynecology (EBCOG).

6. Supporting Innovation in Women’s Health – a Roadmap:
Based on the research and perspectives by Catenion, insightful discussions held during the
FemTechnology Summit workshop “Financing Innovation in Women’s Health” with various
industry stakeholders, and in-depth interviews with policy makers and regulatory experts, aroadmap has been put together. The goal of this roadmap is to serve as a valuable guide tosteer efforts and as a foundation for discussions regarding the necessary actions to be taken inboth the short term and as we shape our long-term strategies.

01

Short-term (~2y)
Identify successful companies and indications with high unmet medical
need in Women’s Health through systematic assessment, triggering
enthusiasm and interest. This would allow the field to be portrayed asa successful business case. Start engaging with regulators and policy
makers to develop mid and long term goals.

02

Mid-term (~4y)
Develop a health economics model to demonstrate the positive businesscase for investing in Women’s Health, supporting funding decisions using
two perspectives:

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→ Business Case for governmental entities (mostly in US and EU) focusing
on return on investing in Women’s Health research by healthcaresavings and economic gains (e.g., working days gained). An example
is the current effort by the NHS Confederation for England’s Women
Health initiative (more info in the next section). This effort requires
a concerted approach and an injection of substantial capital into
Women’s Health (such as the NIH Cancer moonshot which authorized$1.8bn to cancer research over a 7 year period);→ Business Case for private investors focusing on return on investment
for Women’s Health, emphasizing the potential return on investment
and the reduced risk associated with this therapeutic area whensubstantial government backing mirror practices in other domains.

03

Long-term (~7y)
1. Break the silos through a collaborative effort to direct existing andfurther funding, bridging gaps between basic and applied research in
Women’s Health. Such consortia should involve not only pharmaceuticalindustry by also patient advocacy groups, regulators, policy makers,
researchers, translational scientists, etc.
2. Regulatory Incentives: Advocate for regulatory incentives throughestablished consortia to promote development and innovation, learningfrom successful models in other therapeutic areas (e.g., orphan drugs andpediatrics). Engage in education efforts of regulators regarding the key
challenges of drug developers in the field of Women’s Health and how areward based incentive (e.g., longer exclusivity, accelerated development
path,) could lead to more innovation for these patients with high unmet
medical needs.

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7. Call to Action
To follow this roadmap, different actionable strategies can be applied. The relevance of thesestrategies can differ based on your role and perspective as a reader. Whether you are a patient,a Woman’s Health founder, a pharmaceutical executive, a medical doctor, a politician, a healtheconomist, or simply an engaged citizen who values equitable healthcare, these approaches
offer various ways for you to get involved and make a positive impact.
It is evident that a collaborative effort is essential to construct a compelling business casefor governmental entities to fund Women’s Health and help de-risk investment for private
investors. To this end, we invite you to consider engaging with and supporting this field as it
moves forward.
Below, we enumerate various strategies in which you can actively participate:•

Educate and Raise AwarenessLaunch targeted awareness campaigns, raise your voice on social media to shed lighton the wide-ranging health needs of women that go beyond reproductive issues. Shareinformation, stories, and statistics on the existing gaps and challenges in Women’s
Health (e.g., XProjet from Roche, FemTechnology). As professionals within healthcareorganizations, advocate internally for a stronger commitment to research and investment
in areas pertinent to Women’s Health from an R&D perspective (e.g., The Wyss Institute’s
Women’s Health Catalyst at Harvard University).

•

Empower Patient Advocacy
Collaborate with patient advocacy groups, participate if you are a patient, or initiate one if
needed. Share real-life stories and empirical data that illustrate the unmet medical needsin Women’s Health, emphasizing the profound impact on women’s lives and the economy(e.g., The National Polycystic Ovary Syndrome Association, The Endometriosis Association,
The Endometriosis Foundation of America). Help policymakers and politicians understandthe urgency of these issues.

•

Build Credibility Through Collaborations
There is a need for diverse perspectives and interdisciplinary collaboration in Women’s

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FINANCING INNOVATION IN WOMEN’S HEALTHHealth innovation. Discuss and collaborate with healthcare professionals, researchers,tech experts, entrepreneurs, etc. to foster more comprehensive solutions. Engage
with established organizations such as ACOG and EBCOG to enhance credibility when
advocating for policy changes (e.g., The Lancet Commission on Women, Power and Cancer).

•

Establish a Business Case for Women’s HealthSupport organizations and initiatives dedicated to crafting a compelling business casethat attracts investment. An excellent illustration of this approach is the “Women’s HealthAccess Matter” initiative in the United States. Similarly, in England, the NHS Confederation
Initiative is aiming to demonstrate the economic benefits of investing in Women’s Healthto not only advance the country’s Women’s Health strategy and secure sustainablefunding but also to highlight the broader value of investment beyond the NHS (reachout to Bridget Gorham for more information). If you are in a position to contribute tothese initiatives, you can do so by donating or by actively participating in the creation andprovision of the data required.

•

Participate in Clinical Trials
If you are eligible and interested, consider participating in clinical trials related to Women’s
Health. The involvement can contribute to vital research and will also provide valuable
data that can drive innovation.

•

Support Nonprofits and Research Organizations
Numerous nonprofit organizations and research institutes are dedicated to advancing
Women’s Health (e.g., WHAM, SWHR). Consider donating to these organizations,participating in their events, or volunteering.

•

Advocate for Regulatory Support & Engage with Policy Makers
Use your voice to advocate for regulatory incentives similar to those granted to orphan
diseases, for example. These incentives can kickstart much-needed research and innovationin Women’s Health. Write letters, make phone calls, or meet with local representatives toemphasize the significance of Women’s Health and the need for financial support. Or, if
you can, collaborate with regulatory agencies such as the FDA and EMA to highlight the

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unique challenges and opportunities within this field, by discussing some of the following
points:→ Mandatory public reporting of preclinical and clinical trials results segregated by sex→ Increase funding for basic research and for biobanks with segregated data by sex→ Simplified FDA/EMA submissions (develop as the example from ODA)
→ Expedite pathways for innovative treatments and diagnostics in Women’s Health→ Extended patent life for products launched in highly
genericized indications with no innovation in the last 10
years and high unmet medical need•

Showcase Success and Solutions
Highlight successful Women’s Healthinitiatives and innovations thathave effectively addressed unmet
medical needs.

“These can feel like overwhelming challenges but I get
excited about it because you can actually go out inthe world and see some really exciting things that are

Geopgraphical Implications:happening on the ground and you know there’s thepotential to make this look very different. In the same way

While the focus of this reportthat many of these things have changed in our lifetimes,

predominantly centers on innovation

my hope is that still in our lifetime we’ll see more change
happen. (...) Given the amount of treatments that wein women’s health within the United(Roche) have that can actually impact women’s health, I

States and the United Kingdom,

believe we have a very unique, important and urgent role

it is worth noting the potential

to play in getting this dialogue about women’s healthsignificance

of

this

geographicalmore out there.”emphasis. One could speculate that thesecountries are featured prominently due totheir more advanced policies and research
environments pertaining to women’s health.
Nevertheless, it raises an intriguing point

Teresa Graham
CEO Roche Pharmaceuticals

about the potential for Europe to become a pioneering force in this domain. With increasing
politicization of women’s health and reproductive rights in the United States, an opportunity

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may exist for Europe to establish itself as a cutting-edge hub
for innovation in women’s health. If Europe or otherregions, like Asia, were to implement attractive
policies and incentives, they could position
themselves as frontrunners in this critical field,
ultimately fostering positive global impact.
“... we are playing catchup up. Not only do

8. Conclusion

we have to create knowledge for the future,
we actually have to create awareness and

The path to financing innovation in Women’s

advocacy for right now to continue to makeHealth requires a strategic and concerted

sure that dollars get channeled into theeffortdrivenbypolicymaking,women’ health category.”

publicinvestment, and collaboration. Drawing fromsuccessful models and supported by a compellingbusiness case to attract investment to R&D,
access to effective treatments in Women’s
HealthcanMichael Annichine
CEO at Magee-Womens Research Institute and Foundationbecreated. However, it is important to acknowledge that venturing
beyond the scope of reproductive health will require a longer
and more challenging journey. Overall, financing innovationin Women’s Health is an imperative for improving thewell-being of females worldwide as well as a strategic
opportunity for the pharmaceutical industry to develop
Any market-player

novel solutions and address dire unmet medical needs.

who ignores theneeds of women, will
be losing out.

Stephanie Sassman
Portfolio Leader Women’s Health at Roche

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Catenion
Catenion is a management consulting firm devoted to helping pharmaceutical and biotech
companies implement more innovative and effective strategies. Catenion works across multiple
therapeutic areas for the global biopharma industry including Women’s Health.

Authors

Pascal Joly

Ana Rita da Costa

Ilkin Nehls

PartnerManagerManager

For further enquiries please email ana.costa@catenion.com

In Partnership with

Sources
1. Unlocking opportunities in Women’s Healthcare; 2. The WHAM Report; 3. Temkin et al., 2022; 4. FDA.gov; 5. NORD June
2015; 6. WHO; 7. TheScientist.com (March 2021); 8. Zucker and Prendergast, 2020; 9. Woodward, 2019; 10. D’Angelo,
2022; 11. US Bureau of Labor Statistics, 2022; 12. European Commission, 2021

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FINANCING INNOVATION IN WOMEN’S HEALTHCORPORATE AND R&D STRATEGYASSET & COMPANY SCREENING
PORTFOLIO REVIEW & PRIORITIZATIONTARGET IDENTIFICATION & SELECTION

THERAPEUTIC AREA STRATEGY & DISEASE MAPPING

INDICATION EVALUATION & THERAPEUTIC EXPANSION/LCM

CLINICAL DEVELOPMENT STRATEGYSCIENCE & TECHNOLOGY MAPPING

R&D RISK ASSESSMENT
DUE DILIGENCE

WWW.CATENION.COM

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FINANCING INNOVATION IN WOMEN’S HEALTHFemTechnology Summit 2023

WOMEN-CENTRIC CANCER CARE
Women are 34%
more likely thanmen to experience
severe side effects
from cancer
treatments
9 out of 10 men undergoingbrachytherapy for prostate cancer wereasked about their sexual healthvs 1 in 10 women for cervical cancer.
Question Tackled:
Cancer treatment often fails to take into account thepersonal needs women - in order to improve support andrecovery, the holistic (and unique) needs of women must be
taken into account. How can we go about shaping this during
treatment and after the fact?

IN COLLABORATION WITH

FemTechnology Summit 2023

WOMEN CENTRIC CANCER
CARE
Featured at the US Chamber of Commerce
Panel on How Employers Can Better Support Their Female
Employees With Cancer

How You Can Get Involved:
We are looking to showcase case studies of how
Women Centric Cancer Care can be implemented in
the real world. If you are a Corporate, Clinician,Researcher or Startup with data or a case study for us
to highlight - please get in touch at:contact@femtechnology.org

IN COLLABORATION WITH

Creating a Vision of
Women-Centric Cancer Care
(WCCC)
FemTechnology Summit 2023
Discussion Paper

FemTechnology Summit
FemTechnology Summit Discussion Paper:
Creating a Vision of Women’s Centric Cancer Care (WCCC)

Authors and Contributors:
MichaelAnnichine

Magee-Womens Research Institute

Caroline
Mitterdorfer

Levy HealthYasmin Baba

AmilisCzuee Morey

Xena Dx

Shaan Bassi

Inizio Engage XDMelindaMorimoto

Genentech, Inc., A Member of theRoche Group

Jennifer Cain
Birkmose

VivaValet

Deloitte

Amy Bruhn

F. Hoffmann-La Roche

Claudia
NavarroPadillaTina Buchholz

Gyn-Gen-Lehel MVZ, Munich Germany

GilbertOgbewele

F. Hoffmann-La Roche

Maria Louise
Cascabel

VivaValet

Eva Poggio

RoX HealthPaul Chilwesa

F. Hoffmann-La Roche

Margaret
Punch

Deloitte

Aline Clauss

F. Hoffmann-La Roche

Anne Rohinsky
Clement

Aahuti Rai
GE HealthCare

Four Points Health | Conduit Connect(UK)

Linda DaSilva

Deloitte

Emma
Ricci-De
Lucca

Dartmouth College and ROGUE
Innovation + Design

Marissa Fayer

HERhealthEQ & DeepLook Medical

Alex Fisher

AOA DxStephanie
SassmanF. Hoffmann-La Roche

Wendy
Gerhardt

Deloitte

Maike Schmitz

RoX Health

Rachael Griffin

Patient Advocate

Bharati
Shivalkar

Cardiologist (Delta Hospital, Brussels,
Belgium); Pfizer

AngelaHonegger

UE LifeSciences

Michelle
SnowdenF. Hoffmann-La Roche

Bruno Jolain

F. Hoffmann-La Roche

Kyle
Srinivasan

F. Hoffmann-La Roche

Farah
Hassanbhai
KapoorThomas Jefferson University Hospital
Women's Board - Executive Committee

Eva Sum

F. Hoffmann-La Roche

Antje Knöll

F. Hoffmann-La Roche

Blessing
TawariF. Hoffmann-La Roche

Ece Kozlu

Kadir Has University

Oriana Kraft

FemTechnology Summit

AndreasUllrichCharité Universitätsmedizin
Berlin/Germany
Department of Gynaecology

Mitzi
Krockover

WomanCentered, LLC and former
Founding Medical Director, Iris
Cantor-UCLA Women’s Health Center

Bettina
Zimmerman

F. Hoffmann-La Roche

Emanuela
Kufel

Prosoma Digital Therapeutics

Liliane Brunner
HalbachUniversity of Zurich & Artemis Women’s
Health Foundation

Nicola Marcon

F. Hoffmann-La Roche

Members of:Magee-Womens Research Institute,
UPMC Magee-Womens Hospital,
UPMC Hillman Cancer Center, and
UPMC Health Plan

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FemTechnology Summit Discussion Paper:
Creating a Vision of Women’s Centric Cancer Care (WCCC)

Table of Contents
Table of Contents

3

Abstract

4

Definitions

5

I. Background

6

II. A Call to Action from the WCCC Workshop Participants

8

III. A Working Definition of Women-Centric Cancer Care (WCCC)

8

IV. The Cancer Experience for Women

9

V. The Core Steps of a Woman’s Cancer Experience

10

VI. Commitment Statement and Call to Action to Deliver WCCC

12VII. Stakeholder Actions and Advocacy Throughout a Woman’s Cancer Experience

12

A. Caregivers

12

B. Researchers

14

C. Healthcare Providers

16

D. Innovators

18

E. Insurance Payers, Employers and Policymakers

21

Appendix 1: The Expanded WCCC Experience

25

Appendix 2: “How To Guide” for Each Actor

28

A. Caregivers

28

B. Researchers

30

C. Healthcare Providers

33

D. Innovators

36

E. Insurance Payers, Employers and Policymakers

38

Appendix 3: #MyStoryforChange: Her Lived Cancer Experience42
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FemTechnology Summit Discussion Paper:
Creating a Vision of Women’s Centric Cancer Care (WCCC)

Abstract

The FemTechnology Summit focused on creating equitable and women-centric healthcare, convening adiverse group of stakeholders to address the sex and gender gap in healthcare. These included leadersfrom various sectors including women living with or surviving cancer, caregivers, healthcare providers,
researchers, VCs, start-up founders, and other innovators.
Examination of cancer care data unveiled disparities in the experiences of women, shedding light on theurgent need for Women-Centric Cancer Care (WCCC). While summit stakeholders affirmed thatpatient-centric care leads to better outcomes, it was recognized that a woman’s access to such care isoften limited. In response, we are advocating for WCCC to improve the healthcare system to better meetthe needs of women facing cancer.
WCCC focuses on the unique needs of women in cancer treatment and care and is a concrete step
towards the call from the Lancet Commission on Women, Power and Cancer to advance a more
women-centric approach to cancer. It also aligns with recent appeals to “Close the Gender Health Gap”
and “Redesign Healthcare with Women in Mind” emanating from the World Economic Forum (WEF)
Annual Meeting in January 2024.1
We are calling on all healthcare community members to join this effort to provide comprehensive support
for women with cancer, addressing their physical, social, and mental well-being needs. We believe thatcooperation across different sectors is crucial to enhancing the overall cancer care experience forwomen. Through this collaborative effort, we aim to empower women to make informed decisions and toreceive equitable access to cancer prevention and care.
To make WCCC a reality, in this discussion paper we are:● Defining WCCC: Establishing a universally accepted definition.
● Proposing Stakeholder Roles and Responsibilities: Outlining the key actions and advocacy neededfrom each stakeholder throughout a woman’s cancer experience, including:Caregivers● Provide advocacy and support● Maintain self-careResearchers● Conduct sex- and gender-specific research● Include women in studies and research leadership

Healthcare
Providers● Tailor treatments and care
● Facilitate informed decisions based on active listening

Innovators● Develop women-centric solutions● Engage in collaborative design

Insurance Payers &Employers● Reassess coverage policies● Support comprehensive care

Policymakers● Implement women-centric health policies● Allocate funds for women’s health research● Illustrating the WCCC Experience: Proposing an integrated experience that addresses a woman's
needs at each step.
● Formulating Key Questions: Providing a “How To Guide” for each stakeholder to improve care andoutcomes.
1.

https://www.thelancet.com/commissions/women-power-and-cancer;
https://www.mckinsey.com/mhi/our-insights/closing-the-womens-health-gap-a-1-trillion-dollar-opportunity-to-i
mprove-lives-and-economies#/ ;https://www.kearney.com/industry/health/redesigning-healthcare-with-women-in-mind/open-letter

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FemTechnology Summit Discussion Paper:
Creating a Vision of Women’s Centric Cancer Care (WCCC)

Definitions
The concept of gender in women’s health has been a subject of discussion. For the necessity ofalignment, this discussion paper utilizes the Cleveland Clinic’s definition: “Women’s health is for anyone
who needs it, regardless of their sex at birth”.2
Stakeholders across the ecosystem include:
Stakeholders

Groups Included

Caregivers

The families of women living with cancer and other caregivers.

Researchers

Academic researchers, institutes, public and private research organizations,and centers.

Healthcare Providers

Healthcare providers including nurses, nurse practitioners, doctors,
pharmacists, and other allied health professionals.

Innovators

Start-up founders, entrepreneurs, small and medium-sized businesses, large
pharma, biotech, and medical technology firms, and innovation ecosystemfunders like venture capital (VC) firms.

Insurance Payers,
Employers, andPolicymakers

Groups that determine women’s health benefits coverage and funding,including insurance companies, government payers, employers, andpolicymakers.

2. https://health.clevelandclinic.org/what-is-womens-health5

FemTechnology Summit
FemTechnology Summit Discussion Paper:
Creating a Vision of Women’s Centric Cancer Care (WCCC)

I. Background

Cancer care is often considered a non-gendered experience. Yet, upon further examination, significant
disparities in cancer care for women are evident. During the FemTechnology Summit in Basel,
Switzerland, a cross-sector group assembled to consider emerging evidence of women's care gaps andthe actions required to create a women-centric cancer care (WCCC) approach to bridge such gaps.
Research preceding the summit from the Lancet Commission on Women and Cancer in 2020highlighted disparities in healthcare experiences between men and women.3 For example, women are
34% more likely to experience severe side effects from cancer treatments than men.4 Additionally,studies reveal a striking difference in the care focus provided to men and women. For instance, in ahigh-volume cancer center, 9 of 10 men undergoing brachytherapy for prostate cancer were asked
about their sexual health, compared with 1 of 10 women having brachytherapy for cervical cancer.5
The group acknowledged that patient-centric care results in better outcomes and that women are lesslikely to receive tailored care. The group considered, debated, and confirmed that cancer treatment
often fails to take into account the needs of women. A consensus arose that there is both an unmet
need and opportunity for WCCC. The group agreed to act jointly, as a healthcare ecosystem, to shape
the global understanding of what WCCC means and how it can be delivered to better serve women.
The broader societal impact of cancer on women was also considered, particularly their role as
caregivers and the consequences for their families and children when a mother dies of cancer. The
group confirmed a commitment to address questions related to social inequality, cancer risk, andwomen's status in society and a need for a gendered approach.
In the spirit of growing momentum to develop national Women’s Health strategies and policies to enable
WCCC, the group sought to create a clear, universally accepted definition and a vision for implementing
and measuring WCCC in healthcare systems and private sector product development. The group
continues to advocate for WCCC by identifying core actions that lead us toward a renewed healthecosystem that considers and improves the women’s cancer care experience from pre-diagnosis
through survivorship.
Also, at the FemTechnology Summit in Basel, a related workshop championed by Kearney focused on“Redesigning Healthcare with Women in Mind,” leading to an open letter presented at the World
Economic Forum (WEF) Annual Meeting in January 2024. The open letter urges stakeholders across thehealthcare ecosystem to address gender inequalities and work towards a more equitable future in
women’s health.6 This discussion paper on WCCC is a significant step in the right direction. It outlines avision for transforming cancer care for women and identifies key stakeholders needed to turn this vision
into reality.
Further research that has emerged since the FemTechnology Summit reveals the enormous disparity
women face and strengthens the call to action for advancing and investing in WCCC across healthcare
systems globally:

3. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31479-3/fulltext
4. https://www.cancer.gov/news-events/cancer-currents-blog/2022/cancer-treatment-women-severe-side-effects
5.https://www.astro.org/News-and-Publications/News-and-Media-Center/News-Releases/2022/Sexual-side-effects-of-cancer-treatment-often-unad
6. https://www.kearney.com/industry/health/redesigning-healthcare-with-women-in-mind/open-letter

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FemTechnology Summit
FemTechnology Summit Discussion Paper:
Creating a Vision of Women’s Centric Cancer Care (WCCC)● The Lancet Commission on Women, Power, and Cancer report, released in September 2023,
highlights that 2.3 million women die prematurely from cancer each year. The large majority of themortality occurs in low and middle-income countries. Primary prevention and early
detection/screening strategies could avert 1.5 million of these deaths. The additional 800,000
deaths could be prevented if all women everywhere could access optimal cancer care. The report
also underscores that “patriarchy dominates cancer care, research, and policy-making. Those inpositions of power decide what is prioritised, funded, and studied”. This research reinforces theneed for a women-centric approach to cancer and issues a call to action for all stakeholders to be apart of making this change.7● The Economist and the APAC Women’s Cancers Coalition report, released in August 2023,
illuminates the case for investing in women’s cancers in Asia-Pacific, noting that in 2020, almost halfof all breast cancer in the world was in Asia (45%), and Asia represented 58% of all cervical cancer.
The report advocates that "services and programs should be patient-centric and tailored to needsof affected populations in different settings." It also advocates for "considering integrated, holistic
approaches to tackle resource and capacity challenges," bolstering the call for a women-centric,
integrated, and holistic approach.8● The WEF and McKinsey Health Institute report “Closing the Women’s Health Gap: A $1 Trillion
Opportunity to Improve Lives and Economies,” released in January 2024, outlines how addressing
the women's health gap could significantly reduce women's time in poor health by nearly two-thirds,
amounting to over 500 healthier days in a woman's life. The report emphasizes that 34% of thewomen’s health gap is due to inadequate care delivery. By providing sex- and gender-specifichealthcare, the global burden of women's health issues could be decreased by 25 million DALYs
annually, equating to an average of 2.5 healthier days per woman each year.9● "Hiding in Plain Sight: The Healthcare Gender Toll" by Deloitte, released in September 2023,
examines the growing gender disparities in out-of-pocket healthcare costs in the United States. The
report reveals that employed women pay an estimated $15 billion more per year for healthcarecompared to employed men, exacerbating the gender wage disparity. Key factors cited as driving
the higher out-of-pocket costs for women related to cancer screening, including gynecologicalexams and the notably high costs associated with breast cancer imaging.10● The Bill & Melinda Gates Foundation and National Institutes of Health (NIH) "Women's HealthInnovation Opportunity Map,” released in October 2023, identifies high-value opportunities toadvance women's health R&D, including in data generation and analysis, research design, policy,
and training. Some of the areas highlighted relating to WCCC include evaluating sex- andgender-related differences in outcomes and responses to cancer medications (e.g.,chemoprevention, chemotherapy, immunotherapy, and targeted therapy) to inform the developmentof prevention strategies, screening and diagnostic tools, and treatments for lung, colorectal, andgynecological cancers.11
As the mounting research underscores, there is a clear and urgent need for WCCC. In the face of starkdisparities in care, it is our collective mission to ensure that WCCC becomes a standard part of ourhealthcare systems and also a beacon of change, guiding us towards a more equitable and effective
approach to cancer care that recognizes and addresses the unique challenges faced by women.

7. https://www.thelancet.com/commissions/women-power-and-cancer
8.https://impact.economist.com/perspectives/health/impact-and-opportunity-case-investing-womens-cancers-asiapacific
9.https://www.mckinsey.com/mhi/our-insights/closing-the-womens-health-gap-a-1-trillion-dollar-opportunity-to-im
prove-lives-and-economies
10.https://www2.deloitte.com/content/dam/Deloitte/us/Documents/life-sciences-health-care/us-lshc-health-gender-gap.pdf
11. https://orwh.od.nih.gov/sites/orwh/files/docs/womens-health-rnd-opportunity-map_2023_508.pdf

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Creating a Vision of Women’s Centric Cancer Care (WCCC)

II. A Call to Action from the WCCC Workshop
Participants

The group is committed to driving healthcare systems and women-focused entrepreneurial ventures tomake this vision of WCCC a reality. Our commitment is to collaborate within and among eachstakeholder’s domain in cancer care in the spirit of driving more effective outcomes and more fulfilling
lives for women living with cancer and women survivors of cancer. We envision leveraging this
discussion paper to architect better risk assessment, prevention, diagnostic, treatment, product design,service design, research, clinical practice, and advocacy for healthcare financing for WCCC.

III. A Working Definition of Women-Centric Cancer Care
(WCCC)In 2022, over 130 stakeholders were surveyed on the need for WCCC and what it should encompass.
The respondents included women living with cancer, caregivers, healthcare providers, policymakers,
and payers from seven countries across Africa, Europe, the Middle East, North America, and SouthAmerica. The insights shared highlighted a clear need and current gap, with consistent themes
emerging about how women can effectively experience WCCC. Survey findings, workshop feedback,and subsequent discussions led to the development of the following definition:

Women-Centric Cancer Care improves the lives andhealth experiences of all women, regardless of where
they live, by empowering them to make informed
decisions and providing them with evidence-based
prevention and integrated healthcare that is
innovative, accessible, affordable, equitable, tailored,
and holistically delivered.

To make this definition a reality, every stakeholder in the healthcare ecosystem must work toward
comprehensive and inclusive care for women. Women-centric healthcare means enabling women to
express their health needs, desires, and goals confidently. It also means ensuring women are heard,
believed, respected, and supported by a dedicated healthcare team. Quick and easy access to tailored
cancer prevention, screening, diagnosis, treatment, rehabilitation, survivorship support, and, if
necessary, palliative care is crucial. Examples include streamlined screening processes and faster, moreconvenient therapies.
Additionally, as healthcare stakeholders do not operate in isolation, women require coordinated,personalized support throughout their journey, addressing their physical and psychological needs anddaily life challenges. Cross-sectoral collaboration is essential for holistic care that aligns with broader
personal needs, such as fertility consultations before treatment, resources for possible menopausetransition due to treatment, and emotional support during the cancer experience.
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FemTechnology Summit Discussion Paper:
Creating a Vision of Women’s Centric Cancer Care (WCCC)

IV. The Cancer Experience for Women
Understanding the baseline of a woman’s cancer experience is fundamental to improving each step. The
group mapped out the essential steps of this experience, the actions needed from specific healthcare
system stakeholders along the path, and where enhanced cross-functional coordination is required.
Living with cancer is a complex and challenging experience for women, involving multiple stages andsteps. Power imbalances, a tendency to prioritize others' needs over her own, and navigating ahealthcare system not fully tailored to her unique needs exacerbate a woman’s challenges.
The first step begins with listening to and empowering women to take behavioral preventive measures,
including tobacco control, physical activity, eating a healthy diet, reducing alcohol consumption, getting
vaccinated against HPV/HBV, being aware of early signs and symptoms of cancer, and getting screened
based on their age and risk factors. Many women face challenges knowing their risk, getting screened,or seeking diagnosis and are dismissed due to age, race, socioeconomic status, or other intersectional
factors. Barriers to prevention, screening, and diagnosis must be removed to support women.
Various stakeholders support a woman living with cancer, including medical professionals who assist in
diagnosis and treatment and those providing care, support, and guidance. In addition, researchers andinnovators create products and services to aid her at each step. Policymakers, payers, and employers
determine whether she can access the healthcare she needs and at what associated costs.

Listening to Women: Stories for Change
The key to understanding and improving her experience is to listen to her lived story and tailor
the support to her needs. No one can share the example better of the lived experience of awoman with cancer than the woman herself. Throughout this paper, we share the experiences ofmany women living with cancer and their caregivers through their own words that were
submitted to F. Hoffmann-La Roche’s #MyStoryForChange campaign (original text in teal,translation in white).12 Below, we highlight a woman’s story and her hope for better support for
women in their experience:“El apoyo en el viaje del paciente es fundamental para transitarlo de la mejor forma. Lo constaté
luego de mi diagnóstico de Cáncer de Mama. Fue un periodo en el que tuve vivir diferentes
etapas de largas esperas e incertidumbre, donde hubiera sido muy importante contar con un
acompañamiento en la institución para ayudarme a transitar los distintos momentos y dar
respuesta a muchas interrogantes que me generaban ansiedad, angustia. Ojalá más mujerescada día accedan a un diagnóstico temprano y puedan ser acompañadas en este camino.”“Support in the patient's journey is essential to make the best of it. I realised this after mydiagnosis of breast cancer. It was a period in which I had to go through different stages of longwaiting and uncertainty, where it would have been very important to have support in theinstitution to help me through the different moments and answer many questions that caused me
anxiety and anguish. I hope that every day more women have access to an early diagnosis andcan be accompanied along this path.”

12. Roche - My Stories for Change: https://www.roche.com/xproject/xstories

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FemTechnology Summit Discussion Paper:
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V. The Core Steps of a Woman’s Cancer Experience
The graphic below presents a high-level base case of how a woman’s experience flows frompre-diagnosis, prevention, diagnosis, treatment selection, and treatment to survivorship or end-of-lifecare.
A woman makes decisions along her journey typically based on insights from her healthcare provider(s),such as the type and stage of cancer, potential side effects, personal preferences, treatment goals, andaspirations for survivorship. Critical factors could include preserving fertility, quality of life, emotional
well-being, support for possible menopause transition, and sexual health. Women are also increasingly
turning to online sources and patient support groups for information to empower herself in decision
making. Depending on where a woman lives and the breadth of universal health coverage available,another important factor in her decision-making is a clear understanding of what is financiallyaccessible to her during and after her treatment experience. Keeping her preferences in constantconsideration helps maintain her self-determination.
What dictates a fulfilling life for every woman living with cancer is a personal and often culturalcollection of wants, needs, beliefs, and fears. Being clear about these preferences has implications in
the treatment selection, follow-up, monitoring, and survivorship or end-of-life care. Women and theircaregivers have expressed that listening is vital to honoring a woman’s goals. Appendix 1 expands on
creating an integrated WCCC experience, shifting from the current paradigm to one that addresses a
woman's needs at each step.

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FemTechnology Summit Discussion Paper:
Creating a Vision of Women’s Centric Cancer Care (WCCC)

Listening to Women: Stories for Change
Many women living with cancer and survivors are potent advocates for policy change. The
experience of surviving cancer can bolster a woman's interest in raising her voice and advocating
for increased funding, more equitable access, and better treatment options and guidelines forthemselves and others as indicated by the following stories.13
The following quote from a woman living with cancer highlights the critical need for new
screening guidelines based on her cancer diagnostic experience:“It’s time to lower the age of breast screening. Black women don’t fall into the standardized ageof 50 years old to begin breast screening. We are presenting with the disease at far younger
ages (under 50), more aggressive subtypes and later stages. I was denied a mammogram at theage 40 and at 42 when I requested to begin my breast screening. The reason.. I wasn’t 50 yet.
Two years later at the age of 44, I discovered a lump and received a diagnosis of triple negative
breast cancer. Thankfully I am here to tell my story and advocate.”
Appropriate communication with women around cancer risk and the importance of screening is
also vital, as emphasized by the following quote:“I lost a maternal aunt to cervical cancer that was discovered late. Because I was around 14
years old, it did not occur to me until my 20s that she was very young when she died - around 32
years old. I also did not think that she would die. I did my first Pap in my early 20s, and I am now
strict about doing so regularly, or (preferably) a HPV test. The reality is that still in Africa
thousands of women of all ages die from this. Education about screening tends to end in urban
areas or online, and many are not familiar with the latter.”
The following personal account underscores the challenges that women can face in having theirhealthcare preferences acknowledged and respected:“I was diagnosed with breast cancer and chose to have a double mastectomy, even though it
was caught early. I had pre-cancerous formations on the unaffected side and felt it was a matterof time before I faced this battle again. Several providers questioned my "radical" decision andasked if my husband agreed with my choice. I told them it was my choice because it was mybody and he knew I would make the choice that was right for me. There needs to be greater
sensitivity from providers around bodily autonomy, regardless of one's marital status.”

13. F. Hoffmann-La Roche #MyStoryForChange: https://www.roche.com/xproject/xstories

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FemTechnology Summit Discussion Paper:
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VI. Commitment Statement and Call to Action to Deliver
WCCC

We, as leaders from across the healthcare system - representing women living with or surviving cancer,
caregivers, healthcare providers, researchers, innovators, employers, insurance payers, andpolicymakers - pledge to advocate and collaborate within and across our fields to prioritize the needs ofwomen living with cancer. We recognize that healthcare delivery for women relies on collective action
rather than individual efforts. We commit to a shared focus and dedication to advancing
Women-Centric Cancer Care (WCCC) to improve the lives and health experiences of women byempowering them to make educated decisions and delivering equitable and tailored cancer prevention,
diagnosis, and care.

VII. Stakeholder Actions and Advocacy Throughout a
Woman’s Cancer Experience

Cross-sectoral collaboration and coordination throughout a woman’s cancer experience is essential.
Strengthening such collaboration requires all health system stakeholders to understand their roles
clearly. Accordingly, this discussion paper outlines key questions and specific actions for eachstakeholder to enable our shared vision of WCCC.
This cross-functional group of stakeholders has taken the first step to outline actions and ourcommitment in each of these domains:● How women living with cancer and survivors interact with or are impacted by each stakeholder
along her cancer experience.
● How ensuring WCCC is delivered can transform each stakeholder’s role throughout theexperience of women living with cancer and survivors.
● Core questions and actions each stakeholder must ask to enable WCCC to become a reality.

A. Caregivers
Caregivers are integral to WCCC, providing crucial emotional support, aiding decision-making,and ensuring the overall well-being of women living with cancer. This support network, including
professional caregivers, spouses/partners, and family members, contributes significantly to the
comfort and resilience of a woman living with cancer. Key roles for caregivers involve
comprehensive support, effective communication facilitation, assistance with daily living, pain
management decisions, advocacy for the needs of a woman living with cancer, fostering
psychological and emotional well-being, and supporting the needs of the family so the woman
can prioritize her care.
Caregivers may also play a key role in monitoring the condition of a woman living with cancer,
encouraging treatment compliance, providing access to resources, assist in end-of-life care
care decisions, considering cultural sensitivity, upholding her dignity and comfort, advocating
for medical needs, ensuring continuity of care, and assisting in legal and financial decisions.
Caregivers maintaining their self-care is also vital to prevent burnout.
Core questions are suggested to guide caregivers through these responsibilities. These include
understanding family medical history, clarifying and understanding the treatment goals of awoman living with cancer, respecting her preferences, assessing emotional coping, identifying
practical assistance needed, facilitating communication, supporting nutritional needs, providing
social and emotional support, aiding in financial assistance, addressing cultural factors, guiding
survivorship, contributing to community awareness and importantly, promoting caregiverself-care
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Creating a Vision of Women’s Centric Cancer Care (WCCC)

Addressing these questions empowers caregivers to deliver more effective and compassionate
care tailored to the unique needs and preferences of women living with cancer throughout theirexperience. Appendix 2 includes a “How To Guide” for caregivers to help make WCCC a reality,
including key roles, questions to ask, and actions to take.

Caregivers’ Perspectives
Since caregivers have a front-row seat and access to the woman living with cancer during her
experience, they will often have detailed knowledge of her progress and symptoms and can be
advocates for treatment intervention. The following are stories from two caregivers about theirmother’s cancer experience:14“Mi madre empezó a tener sangrados muy fuertes, cólicos e inflamación constante, iba una yotra vez al doctor y siempre le decían lo mismo “colitis” nunca le hicieron más estudios a pesarque ella los pedía directamente decían que estaba loca, fue con un ginecólogo especialista y ledijo que tenía cáncer cérvico uterino en tercera etapa, que estaba a nada de ser terminal, mimadre murió después de 5 años de lucha y me preguntó que hubiera pasado si una de esas
tantas veces le hubieran hecho un studio.”“My mother began to have very heavy bleeding, cramps and constant inflammation, she went to
the doctor again and again and they always told her the same thing “colitis” they never did any
more tests even though she asked for them they said she was crazy, she went to a specialist
gynecologist and he told her she had stage 3 cervical uterine cancer, that she was close to being
terminal, my mother died after 5 years of struggle and I wondered what would have happened if
one of those many times they had done a test.”“Vou contar a historia da minha mãe! Ela começou a sentir dificuldade de respirar, cansaço edores nas costas, procuramos o médico, recebemos o diagnostico de uma bronquite e
começamos o tratamento, mais em dois meses ela piorou muito e procuramos outro médico eele analisando o raio X feito dois meses antes disse que minha mãe tinha uma massa no pulmão
de 10 milímetros e precisávamos investigar, quando foi refeito o exame a massa já tinha tomado
todo o seu pulmão, ou seja minha mãe tinha um câncer super agressivo e veio a falecer em 2
meses.”“I will tell you my mother's story! She began to feel difficulty breathing, tiredness, and back pain,
we went to the doctor, received a diagnosis of bronchitis and started treatment, but in twomonths she got much worse and we went to another doctor and he analyzing the X-ray done twomonths before said that my mother had a mass in her lung of 10 millimeters and we needed toinvestigate, when the exam was redone the mass had already taken all her lung, that is, mymother had a super aggressive cancer and died in 2 months.”

14. Roche - F. Hoffmann-La Roche #MyStoryForChange https://www.roche.com/xproject/xstories

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Caregivers - Key Takeaways:●

Provide Advocacy and Support: Act as advocates for the needs and preferences of thewomen they care for. Offer emotional and practical support in decision-making, daily careroutines, and addressing family needs.

●

Maintain Self-Care: Prioritize self-care to avoid caregiver burnout.

B. Researchers
There is growing recognition that healthcare research traditionally has not adequately
considered the needs of women living with cancer, leading to gaps in understanding andtreatment. Developing more inclusive and beneficial healthcare strategies for women will require
researchers' commitment to rectify this oversight. A critical step is fostering a diverse workforce
inclusive of women investigators and scientists in key research leadership roles.
As noted in the Lancet Commission 2023 report, “sex-related biological differences in cancer
biology and treatment effects can affect treatment outcomes but remain poorly understood andunder-researched.”15 Investigating and understanding women's genetic backgrounds and othersex- and gender-specific differences are essential parts of a personalized, effective, and WCCC
approach.
Every stage of research, from pre-clinical through real-world evidence generation, should utilize
female subjects, animal models, and women living with cancer to comprehend gender-specificresponses and recognize sex as a crucial biological variable. Clinical trial design should also
incorporate a comprehensive analysis of the broader ecosystem, considering biological, social,economic, and cultural factors. Also, research and development is still mostly limited to highincome countries, and within these countries racial and ethnic minorities in addition to women,
are often underrepresented. It is essential to expand clinical and implementation researchacross diverse demographics including sex, race and ethnicity and also to low and middle
income countries; only then will the treatments women need be understood, developed, anddelivered.
Understanding women's preferences is vital, as is developing methodologies for measuringpotential gender-specific differences in outcomes and health experiences, such as pain andwell-being. One mechanism to support the inclusion of women’s perspectives is collaboratingwith advocacy organizations during research and study design to ensure the prioritization of theoutcomes women value. Such collaboration also includes involving women in identifying the
aspects most meaningful to them, such as side effects, possible tradeoffs, and treatment
convenience.
Important examples of how researchers can ensure WCCC is delivered include considering
women-specific approaches to researching and treating cancer typically not considered“women’s cancers”, including lung cancer, colorectal cancer, and beyond. In addition, many
gynecological cancers like endometrial and ovarian cancer are historically under-researched andin need of new diagnostic and treatment approaches.

15. https://www.thelancet.com/commissions/women-power-and-cancer

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Creating a Vision of Women’s Centric Cancer Care (WCCC)

Researchers can uncover important learnings by developing sex-specific disease models andreporting results by sex and gender. Research funders can foster such insights by including sex
and gender metrics in grant requirements. In addition, integrating behavioral science into
research methodologies can address psychosocial aspects of care, ensuring the delivery ofholistic, women-centric care.
Key questions researchers can ask to advance WCCC include:
●
●
●
●
●
●
●
●

Is the study population appropriately representative of women?
What sex or gender-specific biomarkers should be included?
Has sex been included as a biological variable?16
Are appropriate behavioral, psychosocial, and social determinants of health aspects
included in the trial design?
Have women living with or survivors of cancer been involved in the development review
process to ensure their input is considered and communication is clear?
Have consideration been given to intersectional dimensions that could compound sex orgender differences?
Are there design elements that can be incorporated to enable participation by women?
What impact will trial design have on the accessibility of the treatment to women?

Appendix 2 includes a “How To Guide” for researchers to help make WCCC a reality, including
key roles, questions to ask, and actions to take.

Researchers’ Perspectives
Researchers are at the forefront of developing groundbreaking, women-centric innovations inhealthcare, tackling overlooked challenges. Though fraught with uncertainty and risk, their work
is vital in pioneering new therapies, diagnostics, digital solutions, devices, and care models.
These advancements hold the promise of transforming care for all women, including those livingwith cancer, by specifically addressing their unique health needs.
The following quotes from contributing authors in the Research sector underscore their
dedication and commitment to enhancing women’s health. The quotes reflect the ongoing
research efforts and highlight the critical need to incorporate sex as a biological variable inscientific studies, ensuring more equitable healthcare outcomes.
“At Magee-Womens Research Institute, we have hundreds of world-class researchers devoted toadvancing the health of women across their lifetime - from nine months in utero to 90+ years ofhealth and wellness. Our focus is to improve women’s lives by learning more about the various
conditions and diseases from which they suffer. We are fighters for more women in clinical trials
and more research dedicated to women's health and reproductive biology, and we arechangemakers by transforming women's lives to create a better future for us all.” - Michael
Annichine, CEO of Magee-Womens Research Institute"Cancer research must evolve beyond focusing solely on Progression-Free Survival (PFS) andOverall Survival (OS) to include sex as a biological variable, ensuring equal efficacy andpost-cancer quality of life for both sexes. This involves establishing guidelines for researchingsex-specific differences in treatments, side effects, and long-term health impacts, including
fertility and sexual health. Investing in preventive measures, earlier diagnostics, and addressing
long-term effects predominantly experienced by women, like fatigue and lymphedema, is crucial
for a balanced approach to cancer survivorship." - Liliane Brunner Halbach, University of Zurich
and Artemis Women’s Health Foundation

16.https://orwh.od.nih.gov/sex-gender/orwh-mission-area-sex-gender-in-research/nih-policy-on-sex-as-biological-variable

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Creating a Vision of Women’s Centric Cancer Care (WCCC)

Researchers - Key Takeaways:●

Conduct Sex- and Gender-Specific Research: Conduct research that uncovers andaddresses differences in cancer biology and treatment relating to sex and gender.

●

Include Women in Studies and Research Leadership: Ensure clinical trials represent a
broad spectrum of women and support women investigators and scientists in key researchleadership roles.

C. Healthcare Providers
In the realm of WCCC, healthcare providers play a pivotal role in making crucial decisions
tailored to individual needs, diagnosis, stage of cancer, and overall health.
Healthcare providers' key decisions include determining cancer type and stage, assessing
treatment options, helping to set treatment goals, deciding on the treatment plan inclusive ofclinical trials when relevant, addressing fertility preservation, planning follow-ups, and managing
pain. Healthcare providers can also support a woman by ensuring psychological and emotional
support is available and provided, addressing the possible transition to menopause due tocancer treatment, suggesting complementary therapies, and discussing end-of-life care if
necessary.
Upholding women-centric care involves aligning decisions with the woman’s values,
preferences, and goals and fostering and empowering shared decision-making. The emotional
intelligence of healthcare providers is critical, given the complexity and sensitivity of the cancer
experience for women. Healthcare providers should also act as or identify a connector acrossthe multi-disciplinary team, championing communication and coordination among the individuals
providing her care. This shared goal ensures she is aware of and connected to all resources andservices available to support her care.
A set of core questions is proposed to guide healthcare professionals in designing solutions for
women living with cancer. These questions cover medical history, aids for early detection,
details about the cancer, available treatments, and gender-specific considerations. The
questions also address the woman's preferences, collaboration within the healthcare team,psychological support, assistance for both the woman and her caregivers, technology use, asupportive environment considering social and cultural aspects, and understanding long-termcare requirements.
Asking these questions ensures a structured and woman-focused approach throughout thecancer experience, which prioritizes her voice and preferences. By asking the right questions at
the right time, the healthcare team can ascertain important insights from a woman living withcancer, including her wishes, concerns, symptoms, and side effects.
Appendix 2 includes a “How To Guide” for healthcare providers to help make WCCC a reality,
including key roles, questions to ask, and actions to take.

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Creating a Vision of Women’s Centric Cancer Care (WCCC)

Healthcare Providers’ Perspectives
Healthcare providers are instrumental in delivering WCCC, transcending traditional medical careby recognizing the myriad of physical, emotional, psychological, and social challenges womenface during their cancer journey. The following insights from medical and clinical professionals
underscore the importance of this holistic approach, highlighting the need for personalized care,gender-specific research, and active patient involvement in treatment planning:”Providing holistic, woman-centric care in cancer treatment is essential as it encompasses thefull spectrum of challenges women face, including physical, emotional, psychological, and social
factors. By attentively listening and responding to a woman’s unique needs, we can tailor ourcare to address not only the disease but also its impact on their overall quality of life. Thisapproach is about empowering each woman, respecting her voice, and supporting her
comprehensively, and most effectively, on her journey towards healing.” - Mitzi Krockover, MD,
Internist and (former) Founding Medical Director, Iris Cantor - UCLA Women’s Health Center“Every individual is different, and more so men and women when it comes to diagnostics andtherapy. Large, randomized controlled studies are essential to understand the full scope of thesedifferences. However, these studies should be designed from the outset to address individual
variations. Over decades, we've learned the importance of gender-specific research; therefore,
there's a pressing need for more female-focused randomized controlled studies. Furthermore,individual differences must be respected as we dive into single individual counseling and advice
for care and treatment, especially for female (or male) cancer patients.” - Tina Buchholz, MD,
Assistant Professor, Obstetrics, Gynecology, Human Genetics, Reproductive Medicine“Cancer is a long-term journey from diagnosis, which differs from conditions withsingle-intervention therapies such as in trauma. Clinically, 70% of diagnoses are made from thehistory the woman brings to the physicians. Excluding patients from the therapy decision-making
has shown low adherence to the treatment plans. For example, the 5-year plan of adjuvant
hormonal therapy in HR+ breast cancer is more successful if the patient has bought into it and isactively involved in treatment planning. In the last three decades, most cancers diagnosed early
are considered ‘chronic diseases’. Due to the vital importance of quality of life in chronic disease,the desires of the patient and her definition of quality of life are critical for the healthcare
provider to understand and honor." - Paul Chilwesa, MD FCRO, Clinical Oncologist and Global
Population Health Impact Leader, Roche

Healthcare Providers - Key Takeaways:●

Tailor Treatments and Care: Customize cancer care and treatment plans to address eachwoman's unique needs.

●

Facilitate Informed Decisions Based on Active Listening: Listen to, educate, andempower women to make informed choices about their care.

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Creating a Vision of Women’s Centric Cancer Care (WCCC)

D. Innovators
Innovators play a vital role in shaping products, services, and digital solutions that support
women throughout their cancer experience, from diagnosis to survivorship or end-of-life care.
Building from personal experience, cancer survivors and caregivers often find purpose inlaunching businesses to support women living with cancer.
Designing new products and solutions requires a meticulous understanding of women's specificneeds and challenges. Cancer survivors or their caregivers often find purpose by applying thislived experience to starting businesses.
This deep understanding is equally crucial for established researchers and pharmaceuticalcompanies. A commitment to patient-centricity throughout the product development process isessential, ensuring maximal value for women, regardless of where they are in their cancer
experience.
Critical decisions during product design include determining the product type and purpose,considering the cancer type and stage it targets, and prioritizing user-centric design with input
from women living with cancer and caregivers. The first and most important decision is to listen
to a woman to garner trust and understand her experience and aspirations.
Research by McKinsey indicates considerable unmet need and white space for innovation by
Femtech start-ups in Oncology, as depicted in the chart below:17

17. https://www.mckinsey.com/industries/healthcare/our-insights/the-dawn-of-the-femtech-revolution

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Creating a Vision of Women’s Centric Cancer Care (WCCC)

Taking a concept from idea to product delivery requires iterative collaboration with women livingwith cancer, researchers, healthcare providers, and caregivers. Such approaches assurealignment with medical standards, emphasizing ease of use, comfort, and well-being for
women.
To embody a woman-focused approach, innovators need to pose core questions during thedesign phase, including understanding the specific cancer type, common challenges a woman
may face during her experience, psychological and emotional impacts throughout, early
detection strategies, remote healthcare options, and supportive community care are crucial.
Additional paramount considerations include privacy, accessibility, inclusivity, support for
fertility preservation, the transition to menopause, and emotional and psychological well-being.
Innovators must also navigate regulatory compliance, conduct thorough prototyping and testing,plan effective marketing strategies, and offer support resources. Affordability, ethicalconsiderations, and sustainability are key factors, alongside continuous improvement based onuser feedback. Finally, product design must empower women through education, ensuring
privacy and comfort in healthcare facilities, community-based care, and the family unit.
In summary, innovators are essential in delivering WCCC by advancing new products, services,and technologies for each stage of the experience, from cancer prevention to survivorship or
end-of-life care. Innovators can also promote women’s quality of life during and beyond cancer
by designing solutions for the unique experiences of women living with cancer.
Appendix 2 includes a “How To Guide” for innovators to help make WCCC a reality, including key
roles, questions to ask, and actions to take.

Innovators’ Perspectives
In the journey to enhance women's cancer care, innovators play a pivotal role in uncovering newopportunities and developing groundbreaking solutions. From improving the quality of life forpatients to advancing cancer detection technologies to supporting fertility preservation, theimpact of innovation is far-reaching. Let's hear from innovators who are at the forefront of thesetransformative efforts:
The story of the founding of the startup LebensHeldin in Germany demonstrates a caregiver’s
experience that led her to create a startup:18“Qualvolle Todesfälle in meiner Familie haber mich wachgerüttelt. Krebs ist eine Familienkrankheit- doch keiner spricht darüber, wie groß der Schmerz, Angst und Leid der Angehörigen ist undwelche seelischen Narben bleiben. Frauen nach Brustkrebs kämpfen mit ihrem identitätsverlust,
fühlen sich in ihrer Weiblichkeit verletzt, fallen nach der Therapie oft in ein tiefes Loch und fühlen
sich allein gelassen. Deshalb habe ich LebensHeldin! e.V. gegründet, um diese Lücke imGesundheitssystem zu füllen: in jeder Frau steckt eine LebensHeldin!”“Agonizing deaths in my family have shaken me awake. Cancer is a family disease - but no one
talks about how great the pain, fear and suffering of the relatives are and what emotional scars
remain. Women after breast cancer struggle with their loss of identity, feel violated in theirfemininity, often fall into a deep hole after therapy, and feel left alone. That's why I have founded
LebensHeldin! e.V. to fill this gap in the healthcare system: in every woman, there is a
LebensHeldin!” (translated from German, LebensHeldin means “Heroine of Life” - Silke
Linsenmaier, Founder, LebensHeldin

18. F. Hoffmann-La Roche #MyStoryForChange: https://www.roche.com/xproject/xstories

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FemTechnology Summit Discussion Paper:
Creating a Vision of Women’s Centric Cancer Care (WCCC)

DeepLook Medical was inspired to improve the cancer screening process, giving women a better
opportunity for early detection:“At DeepLook Medical, we are committed to ensuring radiologists and oncologists have the bestvisual tools to help their patients. Ensuring better visualization of dense tissue, especially breast
tissue, which affects 45% of all women globally, is our focus to ensure a suspicious mass isn’t
missed in screening mammograms. As dense breasts disproportionately affect Black, Asian, andJewish women, this is also an equity imperative to ensure ALL women have access to the best
quality images in breast cancer screening. Enabling the reduction of anxiety also has significant
health benefits, knowing that all of your breast tissue was visualized, not only the non-denseareas.” - Marissa Fayer, CEO of DeepLook Medical
Levy Health is driven to support access to reproductive healthcare, a topic often not adequately
discussed with women facing cancer:“We at Levy Health are committed to advancing innovation in fertility because many women andcouples still lack access to reproductive healthcare. What is particularly disheartening is the low
number of women who receive education and access to fertility preservation before undergoingcancer treatment. By observing communities that set a positive example, it is evident thatcollaboration and impeccable time management could make significant differences here for many
affected individuals with relatively minimal medical effort. Innovation does not always have to beabout technology; sometimes an open mindset is all that is needed.” - Caroline Mitterdorfer, CEO
and Founder of Levy HealthInnovators - Key Takeaways:●

Develop Women-Centric Solutions: Create products and services focusing on the specificneeds of women with cancer.

●

Engage in Collaborative Design: Involve women living with cancer in the development anddesign process.

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FemTechnology Summit Discussion Paper:
Creating a Vision of Women’s Centric Cancer Care (WCCC)

E. Insurance Payers, Employers, and Policymakers
Insurance payers, employers, and policymakers play pivotal roles in shaping the landscape forand access to women’s cancer prevention and care. A recent Deloitte publication emphasizes
businesses, insurance providers, and policymakers need to reassess benefit coverage tomitigate the higher out-of-pocket burden on female employees.19
Policymakers at Ministries of Health, the United Nations (UN), and Development Agencies shape
healthcare policies crucial for women's cancer care. In 2018, the World Health Organization(WHO) introduced the Cervical Cancer Elimination Initiative, which was adopted in 2020 by theWorld Health Assembly (WHA). The initiative calls for 90-70-90 targets for:● Prevention: 90% of girls to be fully vaccinated for HPV by age 15,● Early detection: 70% of women to be screened using a high-performance test [HPV
DNA-based testing] by age 35 and again by age 45, and● Treatment: 90% of women identified with cervical disease receive treatment.20
In 2021, the WHO introduced the Global Breast Cancer Initiative (GBCI), aiming to reduce breast
cancer mortality by 2.5% per year, which over a 20-year period would save 2.5 million lives. The
GBCI calls for:● Early detection: >60% of invasive cancers are stage I or II at diagnosis,● Timely diagnostics: Diagnostic evaluation, imaging, tissue sampling, and pathology within 60
days, and● Comprehensive cancer management: >80% of patients undergo multimodality treatment
without abandonment.21
The WHO's efforts in tackling women's cancers are creating significant momentum inaccelerating development and increasing access to equitable cancer prevention, early
detection, and treatment for all women, regardless of where they live. Achieving theseobjectives necessitates strengthening healthcare systems and offers a chance to fundcomprehensive, integrated care systems that facilitate WCCC delivery. For example, in 2023,
the WHO AFRO launched a pilot project integrating the breast and cervical cancer initiatives andother non-communicable diseases (NCDs), focusing on creating convenience in how women
access these critical services.22
National policymakers set national targets to reduce mortality and morbidity and drive
incentives into the healthcare system to improve the quality and outcomes of care. Following
these international health priorities and agreed national priorities, they direct resources toward
research funding, determine screening and prevention program scope, and enhance access tocare, particularly for underserved populations.
In addition, insurance payers and employers make critical decisions regarding financial coverage
depth, ranging from diagnostic tests to supportive services. Choices include provider network
selection, prior authorization guidelines, and clinical review processes. They determine accessto specialized care, clinical trial support, drug formulary, fertility preservation coverage,
menopause support, mental well-being services, and palliative care. Moreover, insurance
payers, and employers decide on cost-sharing structures and financial assistance options, withthe goal of mitigating the hurdles faced by women living with cancer.

19. https://www2.deloitte.com/content/dam/Deloitte/us/Documents/life-sciences-health-care/us-lshc-health-gender-gap.pdf
20. https://www.who.int/news/item/19-08-2020-world-health-assembly-adopts-global-strategy-to-accelerate-cervical-cancer-elimination
21. https://www.who.int/initiatives/global-breast-cancer-initiative,
https://iris.who.int/bitstream/handle/10665/365784/9789240067134-eng.pdf
22. https://www.afro.who.int/countries/cote-divoire/news/three-african-countries-pilot-initiative-boost-cervical-and-breast-cancer-care21

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FemTechnology Summit Discussion Paper:
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Innovative options like microinsurance have grown in recent years to address insurance gaps,
with over 250 million people in emerging markets covered by various microinsurance policies.
However, most policies for women focus only on maternal care and there is a significant
opportunity to better tailor policies in areas like women’s cancer care, including prevention,screening, early diagnosis, and treatment.23
Collectively, concerted efforts by insurance payers, employers, and policymakers to ensurecomprehensive and equitable coverage and access decisions can better support the uniqueneeds of women facing cancer. A holistic strategy to improve women's cancer care outcomesrequires a commitment to addressing barriers, promoting prevention and education, supporting
treatment and coverage, and advancing research.
Appendix 2 includes a “How To Guide” for insurance payers, employers, and policymakers to
help make WCCC a reality, including key roles, questions to ask, and actions to take.

Insurance Payers, Employers andPolicymakers Perspectives
Insurance payers, employers, and policymakers play a vital role in shaping WCCC. Theircollaborations and innovative approaches are crucial in providing accessible, comprehensive carefor women, early detection, providing affordable and holistic care options, and supporting
women throughout the cancer experience. Below are insights from key representatives in thesegroups:“UPMC Health Plan, headquartered in Pittsburgh, Pennsylvania, is among the United States
fastest-growing health plans and being owned by the University of Pittsburgh Medical Center(UPMC), we are part of an integrated healthcare delivery system committed to providing ourmembers with better health and the peace of mind they deserve. Led by Diane Holder, our
President and Chief Executive Officer, our goal is to improve the health of our members, including
the many women we serve. We launched a podcast called ‘Good Health, Better World,’ and in our
most recent season we talk about supporting women’s health—body and mind—acrossgenerations, populations, and stages of life. The series includes topics on providing
comprehensive care to women, the complexities of chronic disease in women, prevention as
self-care, disparities in diagnosing and treating breast cancer, and new research frontiers inwomen's health equity.” - Ellen Beckjord, Vice President, Population Health and ClinicalOptimization, UPMC Health Plan
“Achieving women-centric cancer care (WCCC) requires the joint intersectoral collaboration of
governments, academia, non-governmental organizations such as patient organizations, public
and private insurance agencies, and the private healthcare sector. Most of the stakeholders arestill working in silos, and fragmentation of healthcare is the consequence. It is essential toestablish national or regional multi-stakeholder platforms. There is a huge chance to move
forward with WCCC principles and values with the overarching goal of reducing suffering andimproving the survival and quality of life of the women affected.” - Andreas Ullrich, Department
of Gynaecology and Gynae Oncology, Charité Universitätsmedizin and former Adviser to theAssistant Director General Noncommunicable Diseases and Mental Health (NMH cluster) with theWorld Health Organization (WHO) at WHO Headquarters Geneva

23. https://microinsurancenetwork.org/resources/resource-13621 ,https://www.rgare.com/knowledge-center/article/closing-the-gender-gap-the-role-of-inclusive-insurance-in-empowering-women-around-the-world

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FemTechnology Summit
FemTechnology Summit Discussion Paper:
Creating a Vision of Women’s Centric Cancer Care (WCCC)"Our venture, YuBuntu, tackles female cancers (breast, cervical, and ovarian) for its members
through prevention (vaccines, diagnostics, screenings, and education), which drives down
incidence rates and catches cancers early. This unlocks affordable insurance coverage at a levelthat funds some of the latest immunotherapies and innovative treatments. APA Femina Plus,
powered by YuBuntu, is priced to cater to women in the 'missing middle' in Kenya, those withlower-middle incomes for whom healthcare access is limited. Our holistic solution for women's
cancer care aims to empower and inspire more women to take charge of their health andwell-being." - Dan White, CEO, ARK Venture Studio, which is incubating the YuBuntu venture“We recognize the importance of an early diagnosis and want to remove barriers to our womentaking care of themselves. This includes no age restrictions for cancer screenings, expanded
preventive care benefits to include breast MRI/ultrasound at no cost, and financial incentives forour employees and spouses/partners to get preventive screenings. And if she faces a cancer
diagnosis, we want her to have peace of mind in our expansive coverage including biomarker
testing, free remote expert medical reviews, fully paid time off, and robust mental health support- all personalized to her health care needs with the support of her dedicated oncology nurse whowalks the journey with her.” - Melinda Morimoto, Senior Benefits Director, Genentech

Insurance Payers & Employers - Key
Takeaways:●

Reassess Coverage Policies: Modify insurance policies and offerings to make cancer carepathways comprehensive, affordable, and accessible for women.

●

Support Comprehensive Care: Ensure coverage includes a wide range of cancer careservices, including screening, fertility preservation, rehabilitation and occupational
therapy, menopause, and mental well-being support.

Policymakers - Key Takeaways:●

Implement Women-Centric Health Policies: Develop and enforce policies and targets thatprioritize women's health needs in cancer care.

●

Allocate Funds for Women’s Health Research: Increase funding for inclusive research
focused on women's health and cancer care across demographics including race andethnicity and in low, middle, and high income countries.

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FemTechnology Summit Discussion Paper:
Creating a Vision of Women’s Centric Cancer Care (WCCC)

Listening to Women: Stories for Change
In developing this discussion paper, the stories of women calling for change have been our
primary source of inspiration. Here, we share more stories emphasizing the urgent need for
WCCC.24
The following quote illuminates two key challenges women face in getting a diagnosisーthe factthat women tend to put their own health needs behind the needs of others and the fact thatwhen women do seek help, their concerns are often dismissed:“When I was 15 my mom spent months in pain, and because it was ingrained in her that womenshould endure the discomfort and because she lacked help to leave her children at home andtake care of her health, she was reluctant to go to the doctor. When she did, multiple doctor
dismissed her symptoms as a migraine and sinus infections. It wasn’t until 2 full months later,when she was in agonising pain and could not handle it anymore, that she was diagnosed with aform of rare cancer that is even rarer in women. She passed away 2 years later.”During the experience of cancer, women face many challenges that are often not adequately
discussed, leading to uncertainty, confusion, and pain. The following stories highlight two such
critical areasーthe desire for fertility preservation and the transition to menopause:“A los 17 años me diagnosticaron de un fibrosarcoma facial. He tenido 3 recidivas locales ymetástasis pulmonar. Me he hecho quimioterapia y radioterapia. Hace 7 años que terminé lostratamientos y me hago controles cada 4 meses. Afortunadamente el cáncer cesó. Pero mis
posibilidades de ser madre también . Los tratamientos para la congelación de óvulos soncostosos y después de recibir tratamientos oncológicos la sanidad pública no los cubre. Hubiera
marcado la diferencia contar con 6mas asesoramiento sobre las alternativas disponibles.”"At the age of 17 I was diagnosed with a facial fibrosarcoma. I have had 3 local recurrences andpulmonary metastasis. I have undergone chemotherapy and radiotherapy. I finished thetreatments 7 years ago and I have check-ups every 4 months. Fortunately, the cancer stopped.
But so have my chances of becoming a mother. Egg-freezing treatments are expensive; after
receiving oncological treatments, the public health system does not cover them. It would havemade a difference to have more advice on the alternatives available.”“At 37, I was diagnosed with breast cancer. Pushed into menopause, I had operations, chemo,
antibody, and hormone therapies. The focus was on treating my cancer, not talking about
menopause and my mental health suffered. 49.7% of today’s population has, is, or will go throughmenopause, yet doctors still lack education, failing to recognize, diagnose and treat its
symptoms. While society continues to treat menopause as a taboo, women will continue to sufferfrom preventable hormone loss, and workplaces will continue to lose exceptional talent.”

24. F. Hoffmann-La Roche #MyStoryForChange: https://www.roche.com/xproject/xstories

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FemTechnology Summit Discussion Paper:
Creating a Vision of Women’s Centric Cancer Care (WCCC)

Appendix 1: The Expanded WCCC Experience
1. Pre-Diagnosis:
Risk Assessment: This stage begins with identifying risk factors, such as family history, lifestylechoices, cancer history, genetic predispositions, and environmental and occupational factors. In
the world of health-tracking wearables, Innovators who are developing self-monitoring tools,
apps, and trackers have a voice in early detection as their prospective data collection can haveearly indications of pre-clinical disease.

2. Preventive Measures:
Preventive measures include vaccinations (e.g., HPV), regular and focused screenings (e.g.,breast cancer, cervical cancer with high-performance test [HPV DNA-based testing] according
to WHO recommendations25, colorectal cancer, and lung cancer based on eligibility criteria), andadopting a healthy lifestyle. Many women face challenges accessing these measures due tofinancial, cultural, logistical, and educational hurdles. Partnership with healthcare providers andresearchers is key to shortening the time between early signals and diagnostic testing.

3. Diagnosis:
a. Symptom Recognition:
Women, their partners, and families are often the first to notice symptoms, prompting themto seek medical attention. Screening programs or health-tracking apps may also raise analert. Symptoms and changes include: lumps, pain, discomfort, mood shifts, demeanorchanges, or unusual bleeding.
b. Medical Evaluation:
This phase includes consultations, physical examinations, and diagnostic tests (biopsies,
imaging, blood tests, biomarker testing) to confirm the presence and type of cancer. The roleof researchers is vital in developing tests that comprehensively review women’s specificsymptomatology. A skilled diagnostic team aids decision-making and fast action bycoordinating closely with healthcare providers.
c. Staging:
Determining the extent and stage of cancer is crucial for treatment planning.

4. Treatment Experience:a. Shared Decision-Making, Palliative Care and Treatment Goals:
After diagnosis, women and their healthcare team discuss and evaluate the available
treatment options, which may include surgery, chemotherapy, radiation therapy,
immunotherapy, targeted therapy, fertility-preservation options or hormonal therapy. Also at
this time, they will consider treatment convenience including faster administration andflexible dosing and/or decentralized care.

25.https://www.who.int/europe/news/item/11-09-2021-who-recommends-dna-testing-as-a-first-choice-screeningmethod-for-cervical-cancer-prevention

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FemTechnology Summit Discussion Paper:
Creating a Vision of Women’s Centric Cancer Care (WCCC)

b. Treatment Options and Choice:
After diagnosis, women and their healthcare team discuss and evaluate the available
treatment options, which may include surgery, chemotherapy, radiation therapy,
immunotherapy, targeted therapy, fertility-preservation options, hormonal therapy, andgenetic testing. Consideration should be given to treatment convenience, including faster
administration, flexible dosing, and decentralized care. Additionally, the appropriateness ofpalliative care should be assessed given it “improves the quality of life of patients and theirfamilies who are facing challenges associated with life-threatening illness, whether physical,
psychological, social, or spiritual”.26
c. Second Opinions:
Following an initial diagnosis, women may seek second opinions to ensure the chosen
treatment plan is appropriate and aligned with their needs.
d. Treatment Commencement:
Women begin the chosen treatment, which may involve multiple modalities.
e. Management of Side Effects:
Coping with treatment-related side effects and symptoms, like chemo-induced menopause,
requires support and management strategies. Vigilance is necessary among the care team,
the woman living with cancer, and caregivers to monitor side effects and take timely action.
Digital monitoring can provide more seamless side effect management.
f. Care Team Collaboration:
Effective communication and collaboration are essential among healthcare providers, thewoman living with cancer, her family, and caregivers to manage care and side effects andmonitor the quality of life from treatment through survivorship.

5. Remission and Post-Treatment:
a. Response Assessment:
Regular check-ups, scans, and tests monitor the response to treatment. Achieving remission
or a reduction in the disease's presence is a key goal for survivorship. Other important
aspects include preserving sexual health, sexual function, mental well-being, quality of life,
and outlook.
b. Follow-Up Care:
Women continue to receive follow-up care and surveillance for rehabilitation to detect any
signs of recurrence or complications.
c. Psychological and Emotional Support:
Managing the emotional experience is critical throughout diagnosis, treatment, andpost-treatment, including anxiety, depression, and fears of recurrence.

6. Survivorship:a. Life Beyond Cancer:
As time passes, many women transition into the survivorship phase, focusing on living afulfilling life beyond cancer, which may require adjustment as it is not a return to business as
usual in the case of long term impacts such as peripheral neuropathy, treatment-induced
menopause, body image issues, after-effects of surgery, cardiovascular concerns, thepotential for permanent hair loss, and the myriad of other issues that can result from cancer
treatment. For example, women who decide to start a family post-cancer need ongoingsupport to navigate fertility options and possible implications for their long term hormone
therapy treatment.
26. https://www.who.int/europe/news-room/fact-sheets/item/palliative-care

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b. Ongoing Health Maintenance:
Regular follow-up appointments, health screenings, and lifestyle choices are essential for
maintaining overall health.
c. Support and Advocacy:
Survivors and caregivers often become advocates by sharing their stories, supporting others,
and raising cancer awareness. It is not uncommon for survivors and caregivers to launch theirown entrepreneurial ventures and policy advocacy efforts. Partnering with women-centric
funding agencies, venture capitalists, and private equity is vital to transform these ideas into
viable businesses, especially Femtech ventures. Policy advocacy can drive change andfunding to support better healthcare for women.

7. Planning End-of-Life Care:a. Shift Focus of Care:
When the healthcare team determines her cancer can no longer be controlled, care is stillcritical, though it shifts to a focus on quality of life and making her comfortable instead oftreatment with curative intent. It is imperative to listen to her during this time as everyone
experiences end-of-life very differently and with unique needs, as may her loved ones.27
b. Advance Directives:
Since every woman has different needs and wishes, communication with her and her family isessential to ensure decision-making and end-of-life decisions are aligned with her values.
Encouraging the woman living with cancer to have an advance directive in place is highly
recommended.
c. Preparing Affairs:
Beyond advanced directives, it’s important to ensure key paperwork and documents are inplace, including wills and healthcare power of attorney, and that financial documents andbeneficiaries are updated. It is a very individual choice, though some women may want to be
involved in decisions such as funeral planning and organ donation.28
d. Hospice Care and the Final Days:
Consider how she desires to spend her final days, including the potential for hospice care,which can start six months before death is anticipated. Often, people who are dying have afear of being a burden, being abandoned, or concerns regarding loss of dignity or control. It is
important to respect her wishes and spirituality and continue to listen and communicate withher honestly and respectfully - reassuring her that her advance directives will be honored. It
is also critical for caregivers to take care of themselves and be open to asking for help fromothers, as this is an emotionally and physically exhausting time.29

27. https://www.cancer.gov/about-cancer/advanced-cancer/care-choices/care-fact-sheet
28. https://www.usaa.com/inet/wc/advice-retirement-terminally-ill-checklist
29. https://www.cancer.gov/about-cancer/advanced-cancer/care-choices/care-fact-sheet

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Appendix 2: “How To Guide” for Each Stakeholder
Following, we provide a “How to Guide” organized by stakeholders to make WCCC a reality, including
key roles, questions to ask, and actions to take.

A. Caregivers
1. Caregivers - Key Roles During a Woman’s Cancer Experience
Caregivers play a crucial role in decision-making and facilitating physical and emotional comfort
for women living with cancer. They comprise a network of professional caregivers, nurses,
spouses/partners, older children, and family members who support a woman throughout her
experience.
Caregivers are typically the closest link to the woman living with cancer (often a family memberor spouse). They will have unique insights into her preferences, as well as a front-row seat tohow she is tolerating the treatments and cancer care. Such insights can assist decision-making
and care, facilitating her comfort and emotional support.
The key roles we see in caregiving that will enable WCCC
a. Advocacy and Decision-Making:
Advocate for her medical needs, seek second opinions when necessary, and ask questions toensure a thorough understanding of the treatment plan. Determine when and how to
advocate for her needs and preferences to make her voice heard in medical decisions. For
example, prioritize asking questions around topics such as pain management and fertility
preservation and assisting the woman living with cancer in exploring these choices.
b. Communication:
Determine how to facilitate clear and effective communication between the woman living withcancer, her healthcare providers, and the care team. Such communication includes
advocating for the needs of a woman living with cancer and ensuring a common
understanding among the woman and her care team.
c. Emotional Support:
Decide how to provide emotional support and be attentive to the woman’s emotional needs
during treatment. Such support includes identifying when professional counseling may benecessary.
d. Assistance with Daily Living:
Decide how to assist with daily living activities such as personal care, household chores,transportation to medical appointments, and meal preparation, depending on the needs of awoman living with cancer.
e. Monitoring and Reporting:
Decide how to monitor her condition, including tracking symptoms and side effects andcommunicating any changes to the healthcare team.

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f. Access to Resources Including Financial and Legal Support:
Help access resources and services supporting her care, such as transportation services,
home healthcare, and support groups. Such support could also include assisting in legal andfinancial decisions, including health directives, power of attorney, and insurance matters.
g. Dignity, Comfort, and Cultural Sensitivity:
Ensure that her dignity, privacy, and comfort are respected in all aspects of care, from
hospital stays to in-home care. Consider her cultural and religious beliefs and make decisions
that respect and accommodate these values in the care provided.
h. Comprehensive Care Planning:
Encourage and assist her in adhering to the prescribed treatment plan, including taking
medications and attending medical appointments.
Decide how to ensure continuity of care, including transitioning from active treatment tosurvivorship and supporting her long-term well-being.
If the condition of a woman living with cancer becomes terminal, caregivers may need to help
make decisions regarding advanced care, planning hospice care, and end-of-life
preferences.
i. Balance with Self-Care:
Make decisions about personal self-care and ensure that the caregiver maintains their own
physical and emotional well-being to prevent caregiver burnout.

2. Caregivers – Core Questions and Actions to Take During a
Woman’s Cancer Experience
When a loved one’s treatment begins, the process can be overwhelming for everyone, including
the caregiver. For this section, we narrow the definition to family members as caregivers. The
following questions aid caregivers in increasing support for their loved one during the cancer
experience:a. Given the treatment plan of the woman living with cancer, what are the potential side effects
and recovery expectations? Can you help her make her goals clear for her treatment team?
b. What is her family medical history and other existing health conditions that must be
considered in her care? Has genetic screening and associated counseling been done? Are
there implications for other family members or children to be considered?
c. Can you support her in clarifying her personal preferences and goals for care, and how canthese preferences be respected and honored?
d. How is she emotionally and psychologically coping with her cancer diagnosis and treatment?
What signs of distress should be looked for, and how can emotional support be provided?
e. What practical assistance does she need in her daily life, such as help with personal care,household tasks, or transportation to medical appointments? Identifying specific areas where
support is needed is essential.
f. What role can you as a caregiver play in facilitating communication between her and herhealthcare providers? What is that role that she prefers you to have? How can you help withmedical decision-making and advocacy?
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g. How can you as the caregiver support her nutritional needs and dietary preferences during
treatment and recovery? What are the unique cultural, social, and personal factors that may
influence her cancer experience?
h. What can you do to provide social and emotional support and how can you help her engage
with her support network of family and friends?
i. How can you help her navigate her care's financial and insurance aspects, including managing
medical bills and paperwork?
j. How can you support her transition to life beyond cancer treatment? Providing guidance forlife beyond cancer is essential.
By addressing these questions, caregivers can design and provide more effective andcompassionate care for women living with cancer, ensuring that their unique needs andpreferences are met during their cancer experience.
Not to be forgotten is the experience of the caregiver. The caregiver must also consider
strategies to maintain their physical and emotional well-being while caring for their loved one.

B. Researchers
1. Researcher’s Key Roles During a Woman’s Cancer Experience
Healthcare researchers play a crucial role in bridging the gap in cancer research between
women's and men’s cancer experiences, which generate the clinical data that paves the way toimplement WCCC. Researchers' decisions in study design, data analysis, and interpretation
contribute to a more nuanced understanding of gender-specific responses to cancer and informthe development of tailored and effective treatments for women.
Here are key roles and decisions healthcare researchers can take to ensure women's uniqueneeds are comprehensively addressed in cancer research:a. Inclusive Study Designs:
Researchers must adopt inclusive study designs that prioritize the participation of womenacross diverse age groups, ethnicities, and socioeconomic backgrounds. By actively
recruiting a representative sample, studies can capture the full spectrum of experiences ofwomen with cancer, providing insights into potential variations and disparities. Study designs
should consider a woman’s preferences, including endpoints and outcomes. For example:
Does the study consider the daily course of life she encounters? Will the data collected
demonstrate the impact of the treatment on relevant aspects of her quality of life?
b. Sex-Specific Biomarkers:
Identifying sex-specific biomarkers is critical for understanding how cancer manifests
differently in women, enabling the development of targeted diagnostic tools and therapies.
Researchers need to explore and validate biomarkers that are indicative of cancer risk,
progression, and treatment response, specifically in females living with cancer.

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c. Integration of Sex as a Biological Variable (SABV):
Researchers should consistently integrate sex as a biological variable (SABV) in theiranalyses. By acknowledging the biological distinctions between males and females,
researchers can identify sex-specific factors influencing cancer susceptibility, progression,and treatment outcomes. This integrative approach ensures that gender-related differences
are systematically considered in the research process.
d. Diversity in Clinical Trial Enrollment:
Encouraging diversity in clinical trial enrollment is crucial for generating findings that apply toa broad range of women. Researchers must actively address barriers to participation,
considering factors such as transportation, childcare, and cultural sensitivities. This approachensures that clinical trial outcomes are relevant and representative of the diverse populationof women affected by cancer.
e. Behavioral and Psychosocial Research:
Incorporating behavioral and psychosocial research methodologies is essential forunderstanding the holistic impact of cancer on women. Researchers should explore thepsychosocial aspects of cancer, including emotional well-being, coping mechanisms, andsocial support networks. This information contributes to the development of interventions
that address the unique psychological challenges faced by women during their cancer
experience.
f. Analysis of Treatment Variations:
Researchers need to analyze variations in treatment responses between women and men
rigorously. Such analysis includes evaluating the efficacy and side effects of different
treatment modalities, specifically in female populations. Understanding these variations isfundamental to tailoring treatment plans that optimize outcomes for women with cancer.
g. Long-Term Survivorship Research:
Long-term survivorship research is essential for understanding the unique challenges andhealth needs of women who have completed cancer treatment. Researchers should
investigate survivorship's physical, emotional, and social aspects, offering insights into
effective post-treatment care and support.
h. Communication and Education Research:
Researchers should conduct studies on effective communication and educational strategies
tailored to women. Such strategies include exploring the most impactful channels fordisseminating cancer prevention, early detection, and treatment information. Culturally
sensitive and easily accessible communication strategies are crucial for empowering women
to make informed decisions about their health.
i. Intersectional Analyses:
Researchers should employ analyses that consider the intersections of gender with othersocial determinants such as race, ethnicity, and socioeconomic status. Such intersectional
analyses unveil the compounded effects of multiple identities on cancer experiences,
ensuring that research outcomes reflect the diverse realities of women.
j. Advocacy for Policy Changes:
Researchers can contribute to WCCC by advocating for policy changes prioritizing
gender-specific health research. Engaging with policymakers to emphasize the importance offunding and supporting research addressing women's unique needs is crucial for driving
systemic change.
In summary, healthcare researchers are pivotal in promoting WCCC by making informed
research design, analysis, and advocacy decisions. These decisions collectively contribute to acomprehensive understanding of gender-specific factors in cancer, fostering the developmentof tailored and effective interventions for women throughout their cancer experience.
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2. Researcher’s – Core Questions and Actions to Take During a
Woman’s Cancer Experience
When designing cancer research and clinical trials, healthcare researchers must ask criticalquestions to ensure the incorporation of women’s perspectives in cancer prevention, screening,and care. These core questions guide the research process and contribute to a comprehensive
understanding of how cancer affects women, enabling the development of tailoredinterventions.
Here are key questions healthcare researchers should address:
a. Population Representation:
Is the study population representative of the diverse demographics of women affected bycancer? Ensuring diversity in the study population is crucial for generating findings applicable
across various age groups, ethnicities, socioeconomic backgrounds, and geographicallocations.
b. Inclusion of Sex-Specific Biomarkers:
Can biomarkers specific to females be included to provide insights into sex-specificresponses to cancer? Identifying and validating sex and gender-specific biomarkers
contributes to a more nuanced understanding of how cancer manifests in women. This
information is vital for tailoring diagnostic tools and treatment strategies.
c. Sex as a Biological Variable (SABV):How is sex as a biological variable (SABV) integrated into the study design and analyses?
Recognizing sex-specific differences at the biological level is essential for uncovering
gender-specific factors that influence cancer susceptibility, progression, and response totreatment. A systematic integration of SABV ensures a comprehensive examination of these
distinctions.
d. Behavioral and Psychosocial Dimensions:
How are behavioral and psychosocial aspects considered in the research, reflecting theholistic impact of cancer on women? Incorporating behavioral and psychosocial researchmethodologies provides insights into the emotional well-being, coping mechanisms, andsupport networks of women facing cancer. Understanding these dimensions is prioritizing
holistic and patient-centered interventions.
e. Impact of Social Determinants:
What social determinants of health are considered, and how do they intersect with theexperience of women's cancer? Addressing the impact of social determinants, such as race,
ethnicity, socioeconomic status, and cultural factors, is essential for recognizing disparities
and tailoring interventions to the unique circumstances of diverse groups of women.
f. Representation in Clinical Trials:
Is there a proactive effort to enhance the representation of women in clinical trials? Inclusive
representation ensures research findings translate into effective treatments for all women.
Overcoming barriers to participation is essential for equitable inclusion.
g. Communication and Educational Strategies:
How are communication and educational strategies tailored to effectively convey information
to women about cancer prevention, early detection, and treatment options? Designingcommunication strategies that resonate with women's preferences and information needs isvital for empowering them to make informed decisions about their health. Culturally sensitive
and accessible approaches enhance engagement.
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h. Long-Term Survivorship Research:
Are there plans to research the long-term survivorship experiences of women post-cancer
treatment? Investigating the long-term physical, emotional, and social aspects of survivorshipoffers insights into the unique challenges faced by women after completing cancer
treatment. This research informs post-treatment care and support.
i. Intersectional Analyses:
How are intersectional analyses applied to account for the compounded effects of genderwith other social determinants? Considering the intersections of gender with race, ethnicity,and socioeconomic status reveals nuanced insights into the diverse realities of women facing
cancer. Intersectional analyses ensure a more comprehensive understanding.
j. Community Engagement and Advocacy:
Has the community been engaged to advocate for WCCC? Community engagement fosters
collaboration, builds trust, and ensures that research priorities align with the needs ofwomen. Advocacy initiatives contribute to policy changes that prioritize gender andsex-specific health research.
By systematically addressing these core questions, healthcare researchers can design studies
and clinical trials that holistically incorporate the perspective of women's cancer care. Thisapproach advances WCCC by generating evidence-based insights and interventions tailored to
women's unique needs and experiences throughout their cancer experience.

C. Healthcare Providers
1. Healthcare Providers- Key Roles During a Woman’s Cancer
Experience
When treating a woman living with cancer, healthcare professionalsㅡ such as doctors, nurse
practitioners, nurses, pharmacists, and laboratory cliniciansㅡmust make critical decisions
tailored to the woman’s diagnosis, stage of cancer, overall health, and preferences. Given thecomplexity and sensitivity of the cancer experience for women, the emotional intelligence of
these providers is critical in ensuring compassionate and effective care. Often acting as thecentral coordinators of the care continuum, healthcare providers require swift access todiagnostic data for treatment decision support.
The essence of delivering WCCC lies in the multidisciplinary coordination of care with a central
point of contact within the team. This approach always prioritizes the woman’s experience andpreferences at the heart of all medical decisions, integrating both clinical and emotional aspectsof treatment and care.
Some key decisions healthcare providers may make include:
a. Clinical Team Collaboration:
Collaborating with a multidisciplinary clinical team, including specialists, nurses, andsupportive care providers, to ensure communication and coordination across the team toprovide the woman living with cancer comprehensive and integrated care.

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b. Genetic testing and counseling:
Consider if genetic testing (which helps estimate the risk of developing cancer in a lifetime) is
appropriate based on personal or family history. If appropriate, ensure counseling happens
with the woman before and after the testing. Discussions about the implications of findings forher family members should also occur as relevant. Genetic testing is a personal decision to bemade by the woman after she has weighed the risks and benefits with her clinical team.30
c. Diagnosis and Staging:
Determine the specific type of cancer and its stage based on diagnostic tests, such as
biopsies, imaging scans, biomarker testing, and blood work.
d. Shared Decision-Making, Palliative Care, and Treatment Goals:
As part of palliative care, collaborate with the woman living with cancer to set treatment goals(including curative intent) and improve her quality of life (including symptom management)
based on the stage and nature of the cancer. Ensure that decisions throughout care align withher values, preferences, and goals and involve her in shared decision-making.
e. Treatment Plan:
Assess the available treatment options, which may include surgery, chemotherapy, radiation
therapy, immunotherapy, targeted therapy, hormonal therapy, or a combination of these.
● Clinical Trials:
Consider whether the woman living with cancer is eligible for participation in clinical trials
that may offer innovative treatments.
● Surgical Decisions:
If surgery is part of the treatment plan, the doctor will determine the type of surgery (e.g.,
lumpectomy, mastectomy, reconstruction) and the extent of surgical removal.
● Treatment Options:Chemotherapy and radiation therapy, hormonal or targeted therapies, complementary andintegrative therapies, palliative care or end-of-life care
● Timing and Sequence:
Determine the sequence of treatments (e.g., neoadjuvant or adjuvant therapy) and thetiming of follow-up tests and scans.
● Treatment Convenience:
When available, provide options for more convenient treatment modalities that may
provide faster administration of therapies or in a more convenient location such as closer
to or at home.
● Follow-Up and Surveillance:
Develop a plan for regular follow-up visits, surveillance tests, and scans to monitor the
woman’s response to treatment and potential recurrence.
f. Fertility Preservation:
Address fertility concerns and discuss options for fertility preservation before starting cancer
treatment, if relevant to the woman living with cancer. Additionally, providing support for
fertility treatment post-cancer treatment and consideration of options open to the woman if
preservation is not successful.

30.https://www.cancer.net/navigating-cancer-care/cancer-basics/genetics/genetic-testing-cancer-risk#:~:text=Reasons%20to%20consider%20gene
tic%20testing%20for%20cancer&text=A%20personal%20or%20family%20history,steps%20to%20lower%20your%20risk

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Creating a Vision of Women’s Centric Cancer Care (WCCC)

g. Menopause Transition Support:
Address the potential transition to menopause due to cancer treatment and associatedsupport to manage the multitude of symptoms, for example: hot flashes, vaginal dryness,mood swings, sleep disturbances, fatigue, decreased libido, cognitive changes, bone density
loss, weight gain, thinning hair, and dry skin.
h. Psychological and Emotional Support:
Identify the need for psychological support, counseling, or mental well-being services to help
the woman living with cancer cope with the emotional impact of the diagnosis and treatment.
Using yoga techniques to improve muscle tone and pranayama (breathing techniques) to helpbalance the parasympathetic and sympathetic nervous systems. Meditation is a good tool for
healing.31
i. End-of-Life Care and Symptom Management:
Continue her care with a focus on quality of life and making her comfortable instead oftreatment with curative intent if the healthcare team determines her cancer can no longer becontrolled. Since every woman is different in terms of needs and wishes, communication with
her and her family is essential to ensure decision-making and end-of-life decisions arealigned with her values. Encouraging the woman living with cancer to have an advancedirective in place is highly recommended.32
j. Education and Communication:
Providing clear and informative communication to the woman living with cancer and herfamily throughout her experience to ensure she is empowered to make the best decisions forher and her family - a critical part of WCCC.
Keeping the woman’s experience at the core of these decisions is essential to delivering WCCC.
By doing this, along with taking into account the unique circumstances and needs of eachwoman living with cancer, the healthcare provider can provide the best possible care andimprove the quality of life of a woman living with cancer.

2. Healthcare Providers – Core Questions and Actions to Take During
a Woman’s Cancer Experience
When healthcare professionals design solutions for women living with cancer, we advise thatthey consider a comprehensive set of questions to ensure they tailor care and treatments tomeet the unique needs of women.
Here are some core questions they should ask:a. What type of cancer does she have, what biomarkers is she expressing, and what stage isher cancer?
b. Given her medical history and diagnosis, what are the treatment options, potential side
effects, and risks? What are gender-specific considerations that will impact treatment andcare?
c. What are her personal preferences and goals for treatment and care?
d. What psychological and emotional challenges is she facing, and how can we provide
psychological support and counseling?

31. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8191226/
32.https://www.cancer.gov/about-cancer/advanced-cancer/care-choices/care-fact-sheet

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e. What support can we offer to help the woman living with cancer and her family or caregivers
through the cancer experience?
f. What resources, information, and delivery channels can be provided to a woman and herfamily to better understand and manage her condition and treatment? In some instances,
women prefer digital channels, and others prefer face-to-face.
g. What role can technology and digital tools play in enhancing communication, monitoring, andsupport for women living with cancer? Leveraging technology for women-centric care isimportant.
h. How can we create a supportive environment in healthcare facilities, ensuring privacy,
dignity, and comfort for women living with cancer?
i. What are the social, cultural, and socioeconomic factors that may influence a woman's
cancer experience, and how can they be addressed?
j. What are her long-term care and survivorship needs following treatment?
Asking these questions can offer essential insights for healthcare professionals to remain
WCCC-focused. Such questions also provide structure to check in with the woman with cancer
as she navigates her experience, maintaining her self-determination and vision for her life
beyond treatment.

D. Innovators
1. Innovators - Key Roles During a Woman’s Cancer Experience
Designing products for women living with cancer requires carefully considering their specificneeds and challenges. Innovators play a critical role in designing products and services that can
support a woman undergoing cancer screening and treatment. Also relevant is the role ofventure and private equity funds to fund innovation from series A through, if relevant, IPO.
Understanding the user experience is critical in the design phase to ensure women-centricity
and maximal value to potential customers who are women.
Often, innovators are cancer survivors or family members of survivors. Although they bring arich lived experience, they still must listen to the market and the experiences of women livingwith cancer. Regardless of the innovator's size, women-centricity in all aspects of productdevelopment is critical to advancing WCCC.
Innovators must make several key decisions to design and develop products that address
women’s cancer prevention and care needs, including:a. User-Centric Design:
Prioritize user-centric design by involving women living with cancer and caregivers in the
prototyping and development process to enhance her preferences and ease the caregiverburden. Input from women and caregivers is invaluable for creating inclusive, ethical productsthat address women’s preferences, facilitating ease of use.
b. Medical Expertise:
Collaborate with healthcare providers, oncologists, and other experts to ensure that the
product's purpose and type align with medical and regulatory standards and is safe forwomen living with cancer.
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c. Cancer Type and Stage:
Consider the type and stage of cancer for which the product is intended. Different cancers
and treatment phases may require unique solutions.
d. Emotional and Psychological Support:
Consider how the physical or digital product can provide emotional support, boost
self-esteem, or help users cope with the psychological challenges of cancer while seamlessly
integrating with blended care models incorporating health coaches, emotional support
animals, and clinicians in the care continuum.33
e. Ease of Use:
Design products that are easy to use and require minimal effort, especially if users may
experience fatigue, weakness, or cognitive challenges due to treatment.
f. Treatment-Specific Features:
Tailor the product to address treatment-specific needs, such as skin care products for
managing skin changes during chemotherapy or post-surgery recovery garments.
g. Privacy and Dignity:
Respect the privacy and dignity of women living with cancer. Products should be discreet
and sensitive to the user's emotional well-being.
h. Comfort and Well-Being:
Consider the comfort and well-being of women living with cancer. Products should be
comfortable, non-irritating, and enhance the user's overall quality of life.
i. Regulatory Compliance:
Ensure the product complies with relevant regulations, reliable data sources, education, andsafety standards for medical devices or healthcare products.
j. Support and Resources:
Consider support resources, such as user guides, educational materials, or helplines, toenable women living with cancer to use the product effectively.
k. Cost and Affordability:
Evaluate the cost of the product and explore options for affordability, such as partnerships
with insurance providers, patient organizations, NGOs, and charities, as well as healthcare
facilities.
By addressing these key decisions, innovators can develop products that provide valuable,
trusted support and solutions for women living with cancer, contributing to improved quality oflife and well-being during their cancer experience. To ensure trust, including her voice is criticalalong all of these phases, essentially to embody the sentiment that no decisions are made about
her without her.

2. Innovators – Core Questions and Actions to Take When Designing
Products and Services to Support a Woman’s Cancer Experience
Innovators play a vital role in designing products and services that can support a woman
undergoing cancer treatment. Understanding the user experience is critical in the design phaseto ensure women-centricity and maximal value to potential customers who are women. Thoughinnovators often come with rich experience from having had cancer themselves or caregiving
for loved ones, they still must listen into the market, including the experiences of women livingwith cancer.

33. https://www.healthline.com/health/cancer/yoga-poses-for-cancer

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Whether through qualitative or quantitative research, here are some core questions to ask:a. Do you fully understand the type of cancer you wish to design a solution around, e.g. breast
cancer? lung cancer? Are there gender-specific risk factors or considerations for this type ofcancer?
b. What is the psychological and emotional impact of cancer on women, and how can we
provide emotional support?
c. How can we improve early detection and diagnosis for women with this type of cancer?
d. How can access to care and treatment for women in underserved or remote areas beenhanced? Are there remote, digital, or telehealth options available?
e. What technologies and digital tools can facilitate communication, education, and support for
women living with cancer?
f. How can we create a supportive community and peer network for women facing cancer?
g. What are the most effective ways to educate and empower women about cancer prevention
and self-examination? Empowering women with knowledge can be a crucial strategy.
h. How can we ensure privacy, dignity, and comfort in healthcare facilities for women withcancer? Creating a supportive environment is essential.
i. How can we promote survivorship and life beyond cancer for women who have completed
treatment? How is life different for them? Can solutions be designed to support this transition
into the next phase of life?

E. Insurance Payers, Employers, and Policymakers
1. Insurance Payers, Employers, and Policymakers - Key Roles During
a Woman’s Cancer Experience
Insurance payers, employers, and policymakers play crucial roles in determining women's
access to cancer screening and treatment. The decisions taken by these stakeholders will
determine whether a woman living with cancer has insurance coverage as well as the estimatedout-of-pocket cost that will impact her and her family. Such decisions significantly influence
women's access to necessary treatments and support services and reduce catastrophic
expenditure by out-of-pocket payments for health care.
Insurance payers and employers must balance the need to provide comprehensive financial
coverage for women living with cancers to manage costs and ensure the quality andappropriateness of care. This responsibility has been highlighted in the Deloitte publication'Hiding in Plain Sight: The Healthcare Gender Toll' suggesting that employers reassess benefit
coverage to reduce the higher out-of-pocket healthcare costs for female employees.34
Policymakers can improve access and outcomes by shaping healthcare policies to meet theunique needs of women for cancer prevention, screening, and treatment. While policymakers
face the challenge of balancing public health investments within fixed budgets, determining
access eligibility, duration, and cost capping, it is essential to see WCCC as a population-based
investment, not a cost. It has been well described that a woman’s health is connected to her
economic power.35
34. https://www2.deloitte.com/content/dam/Deloitte/us/Documents/life-sciences-health-care/us-lshc-health-gender-gap.pdf
35. https://www.gatesfoundation.org/ideas/articles/womens-health-economic-power;
https://bciu.org/womens-health-is-wealth-how-investing-in-womens-health-directly-improves-economic-outcomes-in-developed-and-developing-m
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Investing in WCCC approaches will add not only life years but also the quality of life that will
enable a woman to return to her role in society, supporting not only the woman but also theeconomy. For example, the APAC Women’s Cancers Coalition report highlighted that “expanding
prevention and screening for breast and cervical cancer is of paramount importance given thedemonstrable positive impact in terms of mortality, economic and productivity gains, and thesocial impact for women, their families, and society.”36
At every turn, these stakeholders make pivotal decisions that shape the scope of access tocancer care, affecting the quality and affordability of treatment, prevention, and outcomes.
Examples of key decisions taken by Insurance Payers and Employers are as follows:a. Wellness and Prevention:
Support by funding and listing as a benefit preventive measures, such as vaccination (e.g.,
HPV), cancer screenings (e.g., breast cancer screening and DNA-based testing for HPV), andwellness programs to promote early detection and healthy lifestyles.
b. Coverage Decisions:
Determining the extent, scope, and sequencing of insurance/financial coverage forcancer-related care, including diagnostic tests, genetic testing, treatments, second opinions,medications (drug formulary), specialized care and supportive services, physical therapy,
rehabilitation, and reconstruction. Coverage also includes the location to receive care and/or
the network of healthcare providers and facilities that are in-network and can provide care to
the woman.
c. Clinical Review and Case Management:
Implement clinical review processes and case management strategies to assess the medical
necessity of treatment plans, coordinate care, and monitor her progress.
d. Mental Well-Being and Support Services:
Determine coverage for mental well-being support, counseling, and support services to help
women cope with the psychological aspects of cancer.
e. Palliative Care and Hospice:
Establish coverage for palliative care and hospice services for women with advanced or
terminal cancer.
f. Continuity of Care:
Plan for continuity of care, including the transition from active treatment to survivorship andthe ongoing monitoring of survivorship-related needs.
g. Cost-Sharing and Financial Assistance:
Decide on cost-sharing structures, co-pays, and deductibles, and explore options forfinancial assistance or support for women facing financial challenges. Where possible, workwith national policymakers to address equity challenges to create incentives for healthcare
payers.
Examples of key decision areas for policymakers at various levels of policymaking are as follows:a. At the international and national levels, the creation of treatment guidelines:
Develop clinical guidelines and pathways that outline evidence-based treatment options for
specific cancer types and stages and help ensure the most appropriate care for women.
These international treatment guidelines bring together evidence-based recommendations
for the treatment of cancer, for example, the World Health Organization (WHO), European
Society for Medical Oncology (ESMO), and National Comprehensive Cancer Care Network®
(NCCN), among others. At the national level, these guidelines are taken up by policymakers
formulating national public health and disease area guidelines, which are translated into
funding priorities for national and private insurance providers to enable localization in clinicalpractice.
39
36. https://impact.economist.com/perspectives/health/impact-and-opportunity-case-investing-womens-cancers-asia-pacificFemTechnology Summit
FemTechnology Summit Discussion Paper:
Creating a Vision of Women’s Centric Cancer Care (WCCC)

b. At the national level, the development of public health priorities that include women’s
perspectives:
In the formulation of national targets for the reduction of morbidity and mortality withtargeted disease funding within the Ministries of Health or in the case of government funding
toward the health sector arising from the Ministry of Defense.
c. At the national level, coordination with government and private insurance Programs:
Ensure coordination with government-funded and private insurance programs to provide
comprehensive coverage to eligible women, ensuring that the gaps between coverage aremanaged with an eye for minimizing out-of-pocket expenditure.
d. At the national and international policy-making and advocacy arena, support advocacy andeducational programs for women living with cancer:
Offer resources and information to help women and their caregivers better understand theirequitable insurance coverage, make informed decisions, and navigate the healthcare system.

2. Insurance Payers, Employers, and Policymakers - Key Questions
to Pose When Designing WCCC Coverage
Insurance payers, employers, and policymakers play a significant role in shaping the healthcare
landscape for women living with cancer. When designing solutions to ensure women-centric
policies, quality care, coverage, employee benefit selection, and patient support, they should
consider several core questions, all of which touch on each area of policy, funding, andcoverage:a. Access to Care:
Are there barriers to accessing cancer screening, diagnosis, and treatment for women, both
geographical as well as comprehensive access to insurance coverage and how can barriers
be removed? Is there adequate coverage for cancer-related care, including screenings,
diagnostic tests, and treatments? For example, can a policymaker create incentives tominimize the dispersion of health centers through the use of digital health tools? Can a payer
fund an integrated pathway of preferred providers? In the case of an employer, can they
select coverage networks that allow for ease of access relative to working location?
b. Prevention and Education:
How can cancer prevention and early detection strategies, such as access to vaccines andscreenings, be promoted to women? Can a policymaker create disease screening awarenessmonths (e.g., breast cancer awareness month in October)? In the workplace: Whateducational initiatives can be implemented to raise awareness of risk factors, symptoms, andpreventive measures?
c. Supportive Care:
What support services can be provided to women living with cancer, such as mental
well-being support, counseling, and palliative care? Are complementary and alternative
therapies covered and accessible? At the national policy level, can laws be passed to extend
family leave to support women undergoing cancer treatment as has been created in the
Family & Medical Leave Act37 that supports the care of young children and elders?
d. Survivorship Care:How can the long-term care and survivorship needs of women who have completed cancer
treatment be addressed? What support is available for managing post-treatment side effects
and transitioning back to life? At the policy level, can commercial incentives be created tosupport firms that employ or are founded by women cancer survivors, as has been applied in
Kenya for Hemophilia patients?38 For insurance providers and employers, are these policies

37. https://www.dol.gov/agencies/whd/fmla
38. https://borgenproject.org/hemophilia

40

FemTechnology Summit
FemTechnology Summit Discussion Paper:
Creating a Vision of Women’s Centric Cancer Care (WCCC)

e. Genetic Testing and Counseling:
For policymakers, are national policy incentives written into the public health guidelines that
open the funding pathway for patients with cancer and their families?
For insurers and employers, does coverage include genetic testing for cancer risk, and if so,for whom and under what circumstances? What genetic counseling services are available andaccessible for women and their families?
f. Fertility Preservation:
Is there coverage and support for fertility preservation options for women who wish to havechildren after cancer treatment?
If national policy incentives exist to incentivize births, how can this be extended to womensurviving cancer? At the insurance level, are funding options available for women who wish to
freeze eggs before cancer treatments?
g. Menopause Support:
Is there coverage and support for treatments to manage symptoms of menopause that arise
from cancer treatment? Are these policies currently funded by insurers and offered in
employee benefit plans?
h. Financial Assistance:
How can the financial burden of cancer treatment for women, including addressing
out-of-pocket costs and copays, be alleviated?
Are there national policies and insurance policies in place to protect women from financial
hardship due to cancer treatment in the case of catastrophic expenditure?
i. Care Coordination:
How can care coordination between healthcare providers be improved to ensure that women
receive comprehensive, integrated cancer care? How can the fragmentation of care delivery
for women living with cancer be reduced through a well-designed public and private healthinsurance system with information sharing, ease of movement, and coordination throughdifferent layers of care?
j. Research and Innovation:
How can research into gender-specific cancer treatments and therapies be encouraged?
What funding and support can be provided to encourage innovation in cancer care forwomen? Is gender-specific data to understand the unique needs and outcomes of women
living with cancer being collected? How can research and data analysis inform policy
decisions to improve care for women?
k. Health Disparities:
What public health and disease area policies can be implemented to address disparities incancer outcomes among different demographic groups of women? How can we ensure thatcare is equitable for all women, regardless of their socio-economic status or geographicallocation? Based on these priorities to mitigate disparities, how can insurance providers
allocate funds to targeted populations to ensure access to screening, diagnosis, andtreatment programs?
By addressing these core questions, insurance payers, employers, and policymakers can design
comprehensive and equitable solutions that prioritize the needs of women living with cancer,
improve access to care, and promote better health outcomes.

41

FemTechnology Summit
FemTechnology Summit Discussion Paper:
Creating a Vision of Women’s Centric Cancer Care (WCCC)

Appendix 3: #MyStoryForChange: Her Lived Cancer
Experience
Below, we include more stories submitted by women who have experienced cancer and their caregivers
to F. Hoffmann-La Roche’s #MyStoryForChange39. These testimonials, shared by women and theircaregivers who have bravely faced cancer, are not just inspiring stories. They are crucial narratives that
underscore the urgency of advancing WCCC. Each story adds a vital perspective to our understanding
and enhances our collective commitment to this important cause. The original submitted story always
appears first in its native language in teal, followed by, if relevant, its English translation in white.

Navigating insurance payers:“En mi experiencia con diagnóstico de cáncer de mama hay 2 grandes obstáculos en lossistemas de salud costarricense. 1. Nunca vas a estar preparado para una noticia de cáncer sin
embargo no existe apoyo emocional y mental desde el diagnostico hasta tratamiento. Tomemos
en cuenta que la mayoría de doctores en este espacio son hombres, y ellos no están preparados
para entender, empatizar, he informar desde la perspectiva femenina, algo tan sencillo como quete preparen con visuales de cómo se va a ver después de la operación y como se verá 8 meses
después de reconstrucción, información es poder por lo que tener la pintura entera es importantey además contar con herramientas de para normalizar mis etapas de perdida y como navegar
mejor cada etapa. 2. La complejidad excesiva de los seguros de salud genera enorme frustración
y estrés innecesario para las familias pasando por estos momentos.”“In my experience with a breast cancer diagnosis there are 2 major obstacles in the Costa Rican
healthcare system. 1. You are never going to be prepared for the news of cancer but there is no
emotional and mental support from diagnosis to treatment. Take into account that most doctors
in this space are men, and they are not prepared to understand, empathize, and inform from thefemale perspective, something as simple as being prepared with visuals of how it will look after
the operation and how it will look 8 months after reconstruction, information is power so having
the whole picture is important and also have tools to normalize my stages of loss and how tobetter navigate each stage. 2. The excessive complexity of health insurance creates enormous
frustration and unnecessary stress for families going through this time.”

The importance of self-advocacy:“I received a Stage 3, triple positive breast cancer diagnosis in 2017, Valentine’s Day. I am not thetype to joke with my health. My body was giving signals. Unfortunately, my doctors did not knowwhat to do prior to the diagnosis. According to them, I was too young, my OB-doctor’s SBE 6months prior ruled out any lumps. 6 months later I was receiving a diagnosis. Stage 3, metastaticto the lymph nodes. Today I am 6 years free. However, I choose to be an advocate. I encourageothers to be body aware, and know how to advocate for themselves.”

39. F. Hoffmann-La Roche #MyStoryForChange: https://www.roche.com/xproject/xstories

42

FemTechnology Summit
FemTechnology Summit Discussion Paper:
Creating a Vision of Women’s Centric Cancer Care (WCCC)

Fighting to be believed:“After two years of my mom being cancer free, I found a lump on my right breast. I immediately
called my gynaecologist and she sent me to a special clinic right away to get further tests.
The first doctor said ‘It’s probably just a cyst’ and that I should come back in a month. So I cameback a month later to see a different doctor. She told me I was ‘paranoid’ and that I wasted hertime - that I was ‘way too young’ to have breast cancer. Half a year later, 2 weeks before my 26th
birthday, I got my breast cancer diagnosis, it had already spread.”

Proving that strong is beautiful:“When suggesting options for post-cancer reconstruction, the surgeon was very concerned
about aesthetics and I just wanted to have function. He suggested using my lat muscle on one
side to build a mound for a new breast. He said I would still be able to lift a bag of groceries. I
now lift weights for my health and shake my head at the thought of destroying my back muscles
so I could have a bigger looking breast. Would a female surgeon have suggested something so
preposterous?”

Living with the emotional toll of a cancer
diagnosis:“Debido a la pandemia dejé de hacerme los checkeos genecológicos que anualmente solía
realizar. Pasó el tiempo y este año retomé mi rutina. Los resultados fueron saliendo y me
detectaron HPV y posibilidad de cáncer al útero. Cuando te dan esta noticia pasan dos cosas: laprimera es que el miedo se apodera de ti porque temes que todo vaya mal. La segunda, es saber
que tienes la privilegio y la fortuna de poder realizarte los exámenes para diagnosticar a tiempo yque muchas mujeres no tienen el mismo acceso a la salud.”“Due to the pandemic I stopped having the gynecological check-ups I used to do every year.
Time passed and this year I resumed my routine. The results came back and they detected HPV
and the possibility of cervical cancer. When you get this news, two things happen: the first is thatfear takes over you because you are afraid that everything is going to go wrong. The second is
knowing that you have the privilege and fortune of being able to have the tests to diagnose intime and that many women do not have the same access to healthcare.”43

FemTechnology Summit
FemTechnology Summit Discussion Paper:
Creating a Vision of Women’s Centric Cancer Care (WCCC)

A daughter struggling to make her mother’s
wishes heard:“My mother battled end stage Leiomyosarcoma a couple years ago. The physicians & hospital
staff would look to our male relatives to make medical decisions on her behalf. At first it was
puzzling for us, however very soon we made it clear that we her daughters were her next of kin
and responsible for input on medical decisions if she was unable to make them. In many cultures
female next of kin are still undermined when in the presence of male relatives. We can play a keyrole in education, bringing change and giving them a voice.”

The ongoing need for new research andinnovation:“My mother died of ovarian cancer in the 1970s. She noticed a ‘lump’ in her vagina that would
appear during her period; but no doctor would examine her during menstruation. When she
stopped bleeding, the lump would recede into her uterus. Finally, she found a doctor that would
examine her during bleeding. He was horrified and immediately scheduled her for surgery. She
went on hormones and it bloated her up terribly. She died. 35 years later, my good friend was puton the same hormones, with the same effect. She died. Treatment has not progressed.”44

FemTechnology Summit 2023

ESG ALIGNMENT FOR WOMEN'S
HEALTH
what we don't measure, we can't see
How can we track the performance of public companies
committed to disclosing their efforts to support women's health?

•

pm

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eve

spa

20% CEOs

p o li c y d

34% executives

rency

women are under-represented
in the boardroom

t

• i

mp

act • represe

a
nt

ti o

n

Questions Tackled: :How can we make women’s health a priority in ESG
frameworks? Ever since ESG became a governmental
priority, people have increasingly started thinking about
the under-representation of women in business, scienceand clinical trials.
How can this be leveraged to make women’s health apriority within governance and provision frameworks?
IN COLLABORATION WITH

Urgency in Addressing Women's Health:
Breaking Barriers and Promoting Equity
FemTechnology (FemTech) Summit 2023:
Environmental, Social, and Governance alignment
on women’s healthPublished: September 2023
00

Urgency in Addressing Women's Health:
Breaking Barriers and Promoting Equity

Women's Health: From
Historical Oversights to
Present-Day Priorities“We hear a lot about personalized
medicine, but we cannot evenunderstand sex-specific care yet” –Oriana Kraft, FemTech Summit Founder01

Urgency in Addressing Women's Health:
Breaking Barriers and Promoting Equity

Introduction
Women's health has historically been overlooked and continues tobe under-addressed, characterized by disparities and challenges inhealth care that demand immediate attention. Despite some
progress in recent years, significant gaps persist. The
FemTechnology (FemTech) Summit, founded by Oriana Kraft,serves as an integrated platform for women's health, bringing
together academic researchers, clinicians, FemTech
entrepreneurs, investors, and leaders from government andindustry. FemTechnology refers to technology focused on
improving women’s health and well-being1. It includes products
like wearables, apps, and medical devices and services such as
telehealth, digital platforms to improve or support women’s
health. As a community of experts at the frontier of women’s
health and digital technologies, the summit sought to disrupt
conventional norms and inspire groundbreaking progress inpromoting health equity for women. Taking place on June 7th,
2023, in Basel, Switzerland, the FemTech Summit witnessed theparticipation of over 150 delegates2 . This global event addressedvarious interconnected issues, including gender bias, improved
health outcomes, the gender data gap, financing innovation for
women's health, the role of media in women's health, and thedevelopment of women-centric treatments across all health caredomains.
During the summit, Deloitte led a workshop aimed at identifying
key environmental, social, and governance (ESG) actions thatwould significantly advance women's health and well-being3. This
workshop marked the beginning of an ongoing discussion on how
FemTech, as a key stakeholder in the health care ecosystem, could
accelerate advancements towards reaching health equity for
women and sustainably improve health outcomes throughappropriate investments.
At the summit, vibrant discussions emerged, highlighting theessential challenges and misconceptions associated with women's
health care across various global regions. Attendees emphasized
the need for transparent impact measurement and identified threepriority areas: awareness, data-driven insights, and affordability.

“The FemTech Summit aims to challenge the status quo and foster
innovation in advancing women's health equity. Taking place onJune 7th, 2023, in Basel, Switzerland, the FemTech Summit
witnessed the participation of over 150 delegates.”02

Urgency in Addressing Women's Health:
Breaking Barriers and Promoting Equity

1. Increase AWARENESS of female health:
Incorporate female-specific content into
health care education systems to challenge
outdated gender biases and stereotypes.

Challenges
Knowledge on women’s health is significantly lacking, resulting inlimited understanding of the impact of diseases affecting women
beyond those related to reproductive and sexual health4-7.
Persistent gaps in awareness and prevalent gender bias contributeto misconceptions surrounding women's health. One prevailing
misconception is that women's health pertains only to sexual andreproductive aspects. However, women's health encompasses
their overall well-being. As an example, the leading cause of death
for women worldwide is cardiovascular disease (CVD) and more
women die from CVD than all types of cancer combined8. In
contrast, the number of awareness campaigns and charities
dedicated to breast cancer is much more than that of CVD forwomen, and it sends a wrong image that breast cancer is theleading cause of death for women in developing countries 9.
Another systemic challenge to awareness is the lack ofcommunication associated with negative stigmas surrounding
diseases of aging women like menopause. Despite its impact on
virtually all women, menopause is rarely discussed openly at home,in the workplace, or at clinics. A survey in the US revealed that 20%
of women wait for more than a year before seeking medical advice
for menopausal symptoms, and 34% have never been diagnosed10.
This underdiagnosis leads to other preventable areas of mental andphysical health deteriorating and worsening the overall quality oflife for women. As of now, initiatives to address the gender healthdisparities during menopause and perimenopause have beenminimal, highlighting a pressing need for more comprehensive
strategies and actions11.

“A survey in the US revealed that 20% of
women wait for more than a year before
seeking medical advice for menopausal
symptoms, and 34% have never been
diagnosed.”03

Urgency in Addressing Women's Health:
Breaking Barriers and Promoting Equity

Actions
To address the challenges in women's health, it is crucial to increase awareness and educate the general public as well as health careproviders with gender-specific content. Providing a comprehensive view of women's health will also override outdated biases andstereotypes. Impactful actions highlighted during the discussion to address the awareness challenges include:01

Update medical education curricula to include comprehensive gender-specific medical information. By covering awide range of conditions beyond reproductive health and providing continuing education on women's health,including gender-sensitive care and communication skills, we can bridge the gap and promote gender equity inhealth care4, 12. Using latest technologies including AI, FemTech can revolutionize medical education, improving
patient outcomes. (social/governance aspects of ESG)

02

Foster interdisciplinary collaboration among health care stakeholders to ensure comprehensive FemTech
investment and continuous growth to innovate women’s health. Give priority to patient education andempowerment through the creation of precise and easily accessible resources, while encouraging open dialogues
with patients. (social aspects of ESG)

03

Raise awareness by implementing United Nation’s sustainable development goals and initiatives into corporate
strategy13. Measure progress to bridge health care gaps and promote equity. For instance, partner with influential
figures to raise awareness about women’s health, sharing their experiences, and advocating for policy changes.
(social/governance aspects of ESG)

04

Monitor the percentage of women in leadership roles. Develop plans to sustain gender parity at the highest levels
while advocating for women's health advancement14. The representation of women in executive committees acrossthe health care sector needs improvement to help progress on health equity. Every institution could advance theirgovernance and gender parity agenda by addressing this call for action. (social/governance aspects of ESG)

Metrics
Potential metrics to evaluate the impact of efforts to raise awareness and support for women's health are:
•
•
•
•
•

04

Ranking of medical universities: Assessing the inclusion of women's health in medical education curricula through university
rankings.
Reporting the amount of financial investment made by venture firms specifically in FemTech startups, indicating active financial
contribution towards achieving health equity for women.
Tracking and reporting the number of initiatives implemented by organizations to raise awareness on women's health. The report
can be part of the annual report.
Under the ESG or corporate social responsibility section to raise awareness and to foster an equitable society.
Percentage of female leaders at the highest level of decision-making bodies within health care ecosystems including government,
NGOs, and industry.

Urgency in Addressing Women's Health:
Breaking Barriers and Promoting Equity

2. DATA-DRIVEN insights and actions: Improveunderstanding of diseases in women bycollecting the right data.
Challenges
There is currently not enough comprehensive data collected on
women's health, despite comprising approximately 50% of the
global population, leading to underdiagnosis and lack of earlyintervention. This need has been overlooked in society andmedicine and is evident in various aspects, such as:• Research funding for diseases affecting mostly women issignificantly lower compared to those prevalent in men15.
• Fewer women participate in clinical trials, hindering ourunderstanding of gender-specific symptoms, side effects andtreatment options. Subsequently biased conclusions can arise

from the use of primarily male subjects, animals, and celllines16.
• Women often feel their health care concerns are dismissed
due to societal gender biases on what should be tolerated by awoman versus a man, therefore symptoms experienced are
not captured as a data point for diagnosis and treatment
consideration17,18.

“Women often feel their health care
concerns are dismissed due tosocietal gender biases on what should
be tolerated by a woman versus aman...”

Actions01

Ensure fair distribution of research and development funding. This requires unbiased decision-making within fundingorganizations, where neither men's nor women's health are given preferential treatment. A study found that a $300 million
investment into women’s health research could yield $13 billion in returns to the economy by reducing health care costs,
improving quality of life, and returning years of productivity to the workforce 19. (social/governance aspects of ESG)

02

Include more female subjects, female-specific animal models, and female-derived cell lines in medical research to enhance
the understanding of disease conditions in women. Health authorities and pharmaceutical companies have already initiatedmeasures to increase gender diversity in clinical trials and aggregate data20, 21. These efforts enable the analysis of data
based on gender, race, and ethnicity, thereby improving health outcomes for all individuals. (social aspects of ESG)

03
04
05

Provide incentives to enforce diversity in clinical trials. Health authorities and relevant stakeholders can implement policies
to promote clinical trial diversity. A breakthrough designation has been implemented to accelerate access to medicine forpatients with life-threatening diseases. Such an accelerated approval path can also be applied to medicines that greatly
improves health equity for underserved populations including women. (social/governance aspects of ESG)

Implement a centralized and publicly accessible data repository of disease prevalence with gender-specific information.
While such information is partially already available online data clustering by gender, race, and ethnicity can be further
improved. It allows for a better monitoring of disease occurrence, identifying contributing factors and symptoms unique towomen, and establishing evidence-based interventions and policies. It democratizes data and promotes informed decisionmaking. FemTech could be an enabling partner for building data solutions. (social/governance aspects of ESG)

Metrics
Potential metrics to measure the impact of better understanding women's health include:••

Disclosure of the allocation of research funding to women's health by funding agencies, research institutions, and biopharmacompanies is a crucial metric that will help identify and adjust disproportionate distribution of investment at innovation stage.
Percentage of female-specific animal models used and female subjects in a clinical trial study to promote clinical trial diversity.

•

Evaluation of the incentives and their impact on gender balance in research studies.

•

Data-driven insights inform health investment decisions both in public and private health care systems and lead to collaborative
initiatives to improve health outcomes for women across all disease domains. The number of times a data source is referenced inapproved business cases for health investment could be an indicator of equitable attention.

06

Urgency in Addressing Women's Health:
Breaking Barriers and Promoting Equity

3. Improve the quality, accessibility, andAFFORDABILITY of health care for women.

Challenges
Social and economic disparities ingrained in our society, worsened by taboo perceptions around
women’s health issues, greatly hinder access to quality care. According to a report of the World
Health Organization, 2 billion people struggle to pay for health care service out of pocket,
including women in marginalized communities, leading to preventable health complications andmortality22. The apparent lack of information, consideration of women’s access and affordability
challenges when developing new care models and innovative treatment is essentially depriving
half of the world’s population of their basic right to equitable health care.

“Social and economic
disparities ingrainedin our society,worsened by taboo
perceptions around
women’s healthissues, greatly hinderaccess to qualitycare.”

Actions
To address these challenges, the following actions can be taken:

01

Leverage innovative methods like telehealth, drone deliveries, and mobile clinics to improve accessibility and reduce
geographical barriers in health care. These solutions not only offer better societal outcomes but are also environmentally
sustainable 23. Utilizing Femtech apps and wearables, patient data can be shared electronically to health care professional
and in return receive diagnosis and prescription without going into a clinic. Mobile clinics and drone delivery bring healthcare directly to underserved communities, minimizing the need for patients to travel long distance. COVID was the mostrecent accelerator that led to an increased leverage of these health care access channels23. Furthermore, this sustainableapproach aligns with environmental conservation goals thereby preserving a healthy planet for a healthy population.
(social/environmental aspects of ESG)

02

Adopt affordable health care models to enhance patient outcomes and ease the health care system's load.
Comprehensive health insurance plans, combined with preventative care initiatives could both ensure affordable care forwomen while also contributing to better lifestyle choices and early diagnosis. (social/governance aspects of ESG)

03

Enhance timely access to accurate data by implementing system-wide electronic health records and interoperable
systems, allowing access to medical history, and enabling timely and accurate diagnoses at all clinics. FemTech could
leverage data science and Generative AI to develop personalized health care solutions for women23. (social/governanceaspects of ESG)

04

Equip pharmacists with the facilities to conduct private consultations for women’s ailments that can be treated by nonprescription medications, thereby discussing symptoms in privacy, and providing affordable treatments in time (e.g.,urinary tract infection medicine, morning-after pill). (social/governance aspects of ESG)

05

Reinforce collaboration among policymakers, academics, health care organizations, insurance providers, and technology
stakeholders. Collaborative research and development among them will reveal evidence-based solutions to provide moreaccessible, affordable, and accurate medical care and eradicate health inequity in health care. This Femtech Summit is an
example of such a collaboration, and we need to continue building this ecosystem. (social/governance aspects of ESG)

07

Urgency in Addressing Women's Health:
Breaking Barriers and Promoting Equity

Metrics
Potential metrics to consider in measuring progress include:
•
•
•
•
•
•

08

Number of patients reached through telehealth who would otherwise not have consulted a physician or received treatment.
Ranking of health insurance offerings that promote preventive and monitoring care for women can provide insights into the level of
support and focus on women's health care within the insurance industry.
Savings in health care costs resulting from early diagnosis.
Increase in quality-adjusted life year rates for diseases prevalent in women.
Reduction in disease-adjusted life rates through affordable treatment and improved adherence.
List and number of local pharmacies per region that are capable of triaging women’s health issues.

Urgency in Addressing Women's Health:
Breaking Barriers and Promoting Equity

Conclusions
Upon the conclusion of our workshops, it is abundantly clear that westand at the precipice of change. Through our diverse organizations,each of us possess an extraordinary capacity to ignite thistransformation in women’s health care and drive change forward,
utilising the myriad of resources at our disposal.
To drive impactful change, forging strong alliances across the healthcare ecosystem is critical. We need to create a sustainable‘community for change' underpinned by collaboration with Femtech
stakeholder to turn the tide in favour of women's health equity.
Importantly, in all our endeavours, let's align our actions withEnvironmental, Social, and Governance (ESG) priorities. Let’s strive
to articulate a narrative promoting an equitable governancestructure that serves as a vital lever for driving meaningful social
impact through women's health equity.
Let’s continue to campaign for improving women's health equity
which has far-reaching implications. It will not only influence
women but society at large. With an urgent and united approach,
we can activate our collective strength, fostering a healthier andmore equitable future.

09

Urgency in Addressing Women's Health:
Breaking Barriers and Promoting Equity

References
1.

Market Definition | FemTech Analytics

2.

Home - FemTechnology Summit 2023

3.

#1 What is ESG? (deloitte.com)

4.

https://www.guttmacher.org/abortion-rights-supreme-court

5.

International and Regional Obligations on sexual andreproductive health and rights | Ipas and UN Human Rights

6.

Reproductive health is part of the economic health of womenand their families | National Women's law center

7.

Financial instability and delays in access to sexual andreproductive health care due to COVID-19 | Journal of
Women's Health (nih.com)

8.

The top 10 causes of death (WHO.int)

9.

Cardiovascular Disease is The Number 1 Killer In Women,
Awareness Makes A Difference (Forbes.com)

14. Advancing women in healthcare leadership: A systematic
review and meta-synthesis of multi-sector evidence onorganizational interventions | The Lancet | eClinicalMedicine
15. Women’s health research lacks funding | Nature
16. Policy: NIH to balance sex in cell and animal studies | Nature
17. The drive for women’s health equity | Office of the Dean |Harvard T.H. Chan School of Public Health
18. Women’s health concerns are dismissed more, studied less |National Geographic
Women's pain is often less thoroughly investigated anddismissed as 'all in your head | The Washington Post
19. The WHAM Report - The WHAM Report
20. Diversity Plans to Improve Enrollment of Participants from
Underrepresented Racial and Ethnic Populations in Clinical
Trials; Draft Guidance for Industry; Availability | FDA

10. State of Menopause Survey – Bonafide (hellobonafide.com)

21. Takeda’s commitment to diversity, equity, and inclusion inclinical research | Takeda

11. Supporting women in the workplace going throughmenopause | World Economic Forum (weforum.org)

22. Universal health coverage (UHC) (WHO.int)

12. Gender Sensitivity in accessing Healthcare services: Evidence
from Saudi Arabia | MDPI
13. THE 17 GOALS | Sustainable Development (un.org)

15

23. https://www.femtech.health/femtech-market-overview

Urgency in Addressing Women's Health:
Breaking Barriers and Promoting Equity

Health Equity Team

Patricia Gee
Swiss Health Equity Lead

Rekha Jacob
Swiss Health Equity Team

pgee@deloitte.chrjjacob@deloitte.ch

Elizabeth Hampson
European Health Equity Lead

Agathe Grisard
Swiss Health Equity Teamehampson@deloitte.co.uk

agrisard@deloitte.ch

Linda DaSilva
Vice President, Sales Executive

Dr Shafagh Dastjani Farahani
European Health Equity Teamlidasilva@deloitte.com

sdastjanifarahani@deloitte.de

Dr Helena Klipan
ESG and Health Equity
hklipan@deloitte.ch

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refraining from action as a result of any material in this publication.
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15

Dr Sonoko Kanai
Swiss Health Equity Teamskanai@deloitte.ch

FemTechnology Summit 2023

REDESIGNING HEALTHCAREWITH WOMEN IN MIND
Sexual Healthwith 89% of men compared to
13% of women Women receive Pain medication

Doctors discussed

16 minutes later than men

in emergency settings
4 years longer
on average to receive a diagnosis
Women wait

for the same disease as men

Women with Type 1 Diabetes
are 37% more likely to diefrom secondary complications than men

Questions Tackled:Modern medicine was not designed with women in mind.
A notable example: women’s reproductive health - puberty,
pregnancy, menopause and beyond - is often treated in isolationfrom other organ systems and conditions with problematic
implications.
How can we ensure these monumental transitions are better
integrated?
The prevalence and manifestation of diseases differs between men
and women - how should that shape the diagnostic tools that areused, how care is accessed, what is considered a ‘vital sign’, what
our definition of the baseline is in what we screen for?
IN COLLABORATION WITH

FemTechnology Summit 2023

REDESIGNING HEALTHCAREWITH WOMEN IN MIND
Open Letter Launched at the World Economic Forum As PartOf The Women’s Health Global Alliance

How You Can Get Involved:
Sign The Open Letter to Join The List of 60+ Signatories
From Across The Healthcare Value Chain Who Have
Committed To Collaborating And Taking Collective Action
To Redesign Healthcare With Women In Mind.

IN COLLABORATION WITH

Photo by Kearney

Redesigning
healthcare withwomen in mind

Foreword

For many years, there was an overlooked inequity at
the heart of the global healthcare industry: one that
continues to have potentially devastating—if notdeadly—consequences for half of the population.
What is it? A decades-long history of inadequateawareness, underinvestment, missed opportunities,
and institutional bias in women’s health.
In today’s world, health equity is by no means a given,and recently, the penny has started to drop thatchange is not only necessary, but long overdue. Moreand more evidence has come to light, showing thatwomen spend a greater part of their lives in ill healthand disability compared with men and are more likely
to have their concerns dismissed, misdiagnosed, or
missed altogether when they do seek help.
In response, high-profile programs such as the World
Economic Forum’s Women’s Health Initiative and
UNFPA’s 2030 Equity Alliance have started to give theissue more consideration, while large corporations
such as Roche, UCB, Philips, Hologic, and GE
Healthcare have picked up the baton in the private
sector. Now more than ever, health outcomes for
women and girls are being specifically addressed.
The digital and data revolution has also enabledsome huge leaps forward. Femtech, the branch oftechnology innovation designed to support andadvance women’s health, has given many womencontrol over their menstrual cycles and hygiene;
fertility, pregnancy, and postpartum treatment;
reproductive, sexual, and family health; preventive
care; and more. The femtech industry is forecast to
be a trillion-dollar sector by 2027. Similarly, digital
health companies such as Owkin and Huma and tech
giants such as Microsoft have turned their attention
toward advancing women’s health in particular,
contributing to addressing a significant data gap.
But at the same time, a dizzying array of statistics
tell us that biological sex and gender continue toform deep fault lines in healthcare provision, which
negatively and disproportionately impact people whoare biologically assigned female at birth and those
who identify as women.

While most theories of health communication,
public health, and medical education currently do
not consider issues of gender or identity, we believe
not widening out this lens has the potential toworsen inequalities within the system. In this report,
we examine the nature of care required and theexperience of care for individuals across biologicalsex and gender. For the purpose of simplicity, we will
use the words “woman” and “women” to apply toanyone who fits either category, unless we are talking
specifically about the female sex or sex-based
differences in healthcare.
This isn’t the first time these issues have beenpresented. The causes are complex, varied, and often
buried under layers of historical norms and bias.
However, in our view, it’s time for practical solutions
and fixes and a lasting commitment to regenerating
women’s health. It is also our view that, like raising achild, closing the women’s health gap will take avillage: companies acting alone will certainly have an
impact, but the step-change required will only comefrom cross-sector collaborations and partnerships.
That’s why this movement, backed by this report,
was born. To create a cross-sector community,
representatives from the healthcare industry,
education, government, the medical profession,
financial investors, and all other parties havecommitted to come together to shape a more
equitable future for women’s health. We arecommitted to change things for the better, together.
Will you join us?

Paula Bellostas Muguerza
Senior Partner and European Healthcare and Life
Sciences Practice Co-Lead, Kearney

Oriana Kraft
Founder and Producer, FemTechnology Summit

Redesigning healthcare with women in mind

1

A tale of two halves

In 2012, four Berlin-based entrepreneurs co-developed
an app called Clue, one of the world’s first technology
tools for tracking menstrual cycles and their side
effects. It proved popular and grew quickly, gaining
three million active monthly users in just two years.
Fast forward to 2022, and Clue had been joined bymany similar solutions, pushing the global menstrual
health app market to a valuation of $1.2 billion.
Even as the demand for and provision of womenspecific healthcare initiatives and tools is on the rise,
policy changes that adversely affect women’s healthare still being enacted, and critical issues remain
unaddressed, as the UK government’s recent rejectionof mandatory menopause training for generalpractitioners (GPs) demonstrates.
This illustrates both the critical need for—andprecarious state of—women’s health today, andit’s just one example of the myriad ways in which
women’s lives and well-being are fundamentallydisadvantaged by a lack of understanding, lack ofdata, lack of investment, and far too often a lack ofinterest in their specific health issues and needs.

Redesigning healthcare with women in mind

2

Women’s health: where is the care?

Several reports have alreadyidentified what has been referred
to as a gender gap in healthcare.
It’s undeniable that the sociallyconstructed norms, attitudes, andbehaviors around what comprises
different genders and identities
holds sway over how people are
regarded within the healthcare
system, what they experience
when they participate in it, andhow this influences their healthoutcomes. It’s also true that
sex-based differences (in otherwords, the biological andanatomical differences between
those assigned male or female atbirth) have a huge influence on allthese factors. In this report, we
examine the specific impacts on
those assigned female at birthand those who identify as women.

Biological sex impacts health
Most people assigned female at birth experience
reproductive health events exclusive to their sex,
namely menstruation, pregnancy, and menopause.
These come with a wide variety of associatedconditions, such as endometriosis, which is thought
to affect 10 percent of reproductive females globally;
perinatal mood and anxiety disorders, which affectaround 15 to 21 percent during or after pregnancy;
pelvic floor disorder, thought to afflict up to a third ofadult females; and menopausal symptoms such as hot
flashes, night sweats, insomnia, and “brain fog,” whichhave been reported as causing one in three women
to face problems coping at work. Interestingly, it wasthese topics, along with mental health, that most
respondents to the UK government’s consultation
on its Women’s Health Strategy for England wanted
to see prioritized.
But the repercussions go far beyond the
reproductive cycle.
Hormonal influences are also at play in conditions
such as osteoporosis, which is four times morecommon in females age 50 and above than in males. If
you’re a member of the female sex, you also are two to
three times more likely to suffer from migraines, aretwice as likely to experience depression and anxiety ordevelop Alzheimer’s disease, and have up to a fourtimes higher risk of autoimmune diseases including
lupus and rheumatoid arthritis. What’s more, within
five years of having a heart attack, almost one in two(47 percent) females will die, develop heart failure, or
have a stroke, compared with 36 percent of males.
Overall, while female life expectancy is generally
longer than that of the male sex across geographies(83 years versus 78 years in the European Union, forexample), females consistently report poorer healththroughout their lives and spend longer in poor health.
Clearly, there is limited awareness of—and/or
willingness to explore how—female health conditions
as well as general health conditions that affect both
sexes, impact females specifically.

Redesigning healthcare with women in mind3

On the other side of the coin are issues related togender, which can be trickier to uncover and root out,
given their importance in shaping identity at all levelsof society and the many biases and stereotypes thatcome in their wake.

“The history of
medicine, of illness,is every bit as socialand cultural as it isscientific.”
Elinor Cleghorn, Time magazine“Dementia
disproportionately
aﬀects women, bothas patients and as
primary caregivers.
This double burden
underscores a criticalneed for redesigning
healthcare witha female-centric
approach.”
Carl R. Hanna, PhD, CEO/Co-Founder,
Evva Health

Gender norms and biases also
impact health
The great double bind in women’s health today isthat, on the one hand, women are routinely treateddifferently from men because of the sex-based,biological differences between males and females,
and on the other, they are treated as an “averagemale” because medicine hasn’t yet interrogated thesedifferences sufficiently. What impact does this have?
There’s a persistent stigma around female andwomen’s health topics
This is particularly the case when it comes tomenstruation, sexual and reproductive health, andmental well-being (hysteria, coming from the Greek
word for uterus, being routinely used to explain manyof the symptoms reported by women historically).
Even today, almost one in two women (42 percent)have experienced period shaming, while according toa Public Health England report, less than half of thoseexperiencing severe reproductive symptoms havesought help.
In many ways, whether due to a lack of understanding,social taboos, or a combination of these and otherfactors, so-called “women’s issues” such as heavy
bleeding, period pain, menopause symptoms,
contraceptive side effects, and even birth damage
have become normalized.
It’s not difficult to see why women feel hard done byin this respect if we look at some other statistics. For
example, in one 2022 women’s health survey, almost
30 percent of participants said that their concerns
had been dismissed by a healthcare provider, while
15 percent said their provider didn’t believe they
were telling the truth. Elsewhere, women attending
emergency departments are less likely to be taken
seriously and wait longer for opioid painkillers whenreporting acute pain. This is despite the fact thatwomen are more likely to seek out healthcare thanmen, a fact that could be problematic in itself.
Sixty-two percent of people with autoimmune
disease (a population dominated by women) havebeen labeled “chronic complainers” by doctors.

Redesigning healthcare with women in mind

4

Women-specific conditions are under-researched,under-represented, and under-funded
Something that might have escaped many people’s
attention is women’s exclusion from clinical trials
following the thalidomide scandal, which led tobabies being damaged in the womb. In truth, they
have been routinely excluded for years on the basisthat hormonal fluctuations could skew results. It
wasn’t until 1993 that the United States National
Institutes of Health (NIH) mandated women’s
inclusion in trials, meaning that 30 to 40 years ofprogress was almost entirely devoted to the malebody—justified by a belief that what would work for
one sex would work for the other.
The repercussions of this are still being felt today. For
example, although women account for 70 percent ofchronic pain patients, 80 percent of pain medication
has been tested only on men or male mice. Goingback to heart failure, which we know is more prevalent
in women following a heart attack, the NIH reported in
2022 that the proportion of women enrolled in clinical
trials for the condition had remained stagnant ataround 20 to 30 percent since the 1980s.
When it comes to investment, even government
health agencies such as the NIH are now revealing ahuge funding gap in women’s health research, withconditions that have been found to disproportionately
affect women (such as mental illness, headaches,
migraine, and anxiety disorders) receiving significantly
lower funding relative to their burden on the
population compared with those that affect males.
As an example, The WHAM Report found that womenaccount for 78 percent of autoimmune disease
patients in the United States, yet only 7 percent of
NIH funding for rheumatoid arthritis goes to womenfocused research. In the UK, only a few years ago,less than 2.5 percent of publicly funded research wasdedicated to reproductive health, although one
in three women will suffer from reproductive healthissues during their lifetime. Looking farther afield,
women’s digital health start-ups accounted for only
3 percent of global digital health funding in 2020.

“There has been ashocking lack ofinvestment inunderstanding thebiology of conditions
that disproportionately
aﬀect women and girls.
… In nearly threequarters of the cases
where a disease has
aﬀected primarily one
gender, NIH funding
has favored males.”Bill & Melinda Gates Foundation, Women’s HealthInnovations program
Perhaps none of this is surprising when we consider
medical education, which has an equally long historyof male dominance, and of differentiating women
primarily based on the reproductive system. The
Reference Man—white, age 20 to 30, five feet seveninches tall, and weighing 154 pounds—was firstdeveloped in the 1970s to understand safe levels ofradiation. It is still used in anatomy classes, a staple
part of the medical curriculum, and as a standard fortransplant organ sizes. Until 1991, it was also used(with reproductive organs added) to represent
women, who were effectively treated as “small men.”

Redesigning healthcare with women in mind

5

This approach has not only limited many doctors’ability to recognize potential symptoms relating tofemale-specific health conditions and sex-specificdifferences in others; it has also had the trickle-down
effect of preventing patients from acting as informed
advocates for their own care. In 2021, a Freedom ofInformation Act request submitted to the UK’s
medical schools found that 41 percent did not havemandatory menopause education on the curriculum,
the expectation being that students would gain thisknowledge on GP training placements.
On the patient side of the equation, research by
University College London recently revealed that ninein 10 women were never taught about menopause atschool and that more than 60 percent only started
looking for information about it once they started toexperience symptoms. Fewer than 20 percent of UK
women feel they have adequate information on a
range of gynecological conditions from menstrualwell-being to gynecological cancers, menopause,
specialist services for victims of gender-based
violence, fibrosis, and endometriosis.
What’s more, none of these findings have delved into
the specific issues that are experienced bytransgender women. In a letter to the editor of theMedical Education journal, two then-student doctors
stated that issues regarding transgender patientswere often missing from their program of studies,“even in genitourinary medicine and sexual health,where this is vitally important.”
Taking an even broader view, social factors suchas income, education, employment, and living
environment, along with other characterizations
including race, class, and sexuality, also play ahuge role in determining women’s health outcomes.
Often, these add additional layers of inequity.
Just as a few examples, we know that 95 percent
of maternal deaths occur in low and lower middleincome countries, that LGBTQ+ individuals suffer
poorer mental health and have a higher suicide risk
than their heterosexual counterparts, and that Black
women face higher rates of certain chronic
conditions such as anemia, cardiovascular disease,and obesity, leading to excess mortality comparedto other women in the United States.

Data is patchy, at best
All of these issues and more continue to contributeto a massive, woman-shaped gap in medical data,with blind spots in exactly the places they are neededto drive decisions on everything from research topics
and funding to treatment development, education
programs, resource allocation, and public awareness.
Like every other sector, healthcare has benefitedenormously from the digital revolution in recent
years, with the result that more data is being
produced than ever before. However, women’s healthis still in catch-up mode. Whether from a lack ofcommon understanding about the issues that fallunder this umbrella, gaps in reported data when
women do interact with the healthcare system,
national reporting systems that lump everyone
together (even the World Health Organization’s global
health statistics have only been categorized by sex
since 2019, indicating the scale of the challengehere), or analysis that doesn’t accurately reflect theexperience of women, the problems they face atevery stage of the healthcare process, as we will seein the next section, only compound the problem.

Like every othersector, healthcare
has benefitedenormously fromthe digital revolution
in recent years.
However, women’s
health is still incatch-up mode.
Redesigning healthcare with women in mind

6

Worse outcomes for women, acrossthe board

If we look at women’s experienceof the current health system on thisbasis, we can see that they sufferfrom worse health outcomesthroughout the healthcare process,from pre-diagnosis to ongoing care.
Pre-diagnosis
As we have discussed, women are more likely thanmen to have their conditions downplayed or ascribed
to mental health issues, especially when it comes tochronic pain and autoimmune disease, which often
lead to anxiety, depression, or even suicidal thoughts.
As a result, they face lingering conditions withworsening symptoms that are poorly managed. On
top of this, there are too many stories to mention of
women having to persistently advocate forthemselves to secure a diagnosis, often over multiple
visits, months, or years.

Diagnosis
There’s also plenty of evidence that women facedelayed or inaccurate diagnoses as a result ofhealthcare practitioners’ lack of detailed insight into
female-specific conditions or how general healthconditions present differently in women:— One study including data from the entire Danish
population found that women wait four years
longer on average than men to receive a diagnosis
across a range of more than 700 diseases.
— Women are seven times more likely to have a heart
condition misdiagnosed or be discharged during
a heart attack, according to a report by the World
Economic Forum.
— Even as female-specific diseases such as
endometriosis are becoming better understood,
the same report indicates it takes 10 years on
average for the condition to be diagnosed, asituation that is only compounded by a lack of
non-invasive diagnostic tools.
— Despite sexual function issues being a commonside effect of cancer treatment, female patientsare asked about their sexual health 41 percent
less often than men.
The specialized nature of medicine that allows
patients to see particular healthcare providers fordifferent conditions also means that vital information
can slip between the cracks, meaning missed
opportunities to connect symptoms and provide
accurate and timely diagnoses.
One prime example for women is data collection
during and after pregnancy, which could be used to
identify indicators of future health. If we consider thefact that women with gestational diabetes are more
likely to develop type 2 diabetes at a later stage or thatthose who develop pre-eclampsia or hypertension
during pregnancy are more likely to experience a
stroke or cardiovascular disease at another point intheir life, the case for breaking down these barriers
becomes even clearer.

Redesigning healthcare with women in mind

7

Treatment

Post-treatment“Reference Man” syndrome rears its head again at
the treatment stage, a spillover from research
approaches designed around men and male animals.
Respondents to a UK government consultation on
women’s health called out limited discussion oftreatment options and the risks associated withthese, and treatment preferences being ignored as
examples of not being listened to by healthcare
professionals. For example, it’s been found thatwomen are half as likely as men to receive treatment
for cardiovascular disease, and many women withchronic illnesses are required to stop taking essential
medication during pregnancy due to drugs nothaving been tested during gestation.

This is often limited. Four in 10 of the women who
responded to the UK government’s consultation
on women’s health reported not being listened towhen discussing follow-up care. Many of the poor
experiences cited related to the period following
childbirth or baby loss, while a smaller number felt
this was lacking when they needed help withmedication side effects.

Since 2000, women have reported 52 percent more
frequent adverse effects from drugs than men, andof the 10 prescription drugs taken off the market by
the United States Food and Drug Administration (FDA)
between 1997 and 2000 because of serious adverse
effects, eight of these caused greater health risks
in women.

Evidence also points to women experiencing
additional complications and comorbidities comparedwith men, which is not surprising given the focus on
how diseases and treatments affect the male body. For
example, a woman with type 1 diabetes is 37 percent
more likely to die from a stroke than a man with thesame condition and 44 percent more likely to die fromkidney disease. Another study found that women wereconsistently less likely to stick to the prescribed
regimens for diabetes and cardiovascular disease, forexample, which could potentially be linked to the factthat they experience more side effects.
Clearly, so long as the medical and healthcare
professions continue to prioritize the Reference Man,
women will continue to face poorer treatment andlong-term care options.

“Women fare morepoorly compared withmen in relation todisease prevalence,
access to healthcare,and outcomes after
treatment.”
Neena Modi, The British Medical Association

Redesigning healthcare with women in mind8

Of course, there are knock-on effects from thisexperience of care that affect women both
psychologically and economically.
In addition to experiencing stigma, shame, andjudgment on the basis of sex or gender, many
women feel sidelined, unsupported, and evenpatronized by the medical profession. As a result,
their experience is minimized, and they often
disengage from the care process or fail to adhere
to their treatment programs. As one paper that
addresses male dominance in medical education
describes, there is congruence between what we
think, say, and do, and “part of empathy involves
placing primacy on the patient’s experiences andexpertise, allowing practitioners to set aside theirown expectations of medical omnipotence.”
Ultimately, if trust is lost in the healthcare system,
individuals are less likely to listen to experts orengage in maintaining their own health.

Really, what we have discussed here is only the tipof the iceberg: there are many more studies andstatistics that demonstrate the damaging effects ofcontinuing with the status quo in women’s health.
What’s more, investing in women’s health is not only
a moral imperative; it also makes economic sense.
As an article in the British Medical Journal states,“Human rights, theory, evidence, and common sense
all suggest that greater investment in women’s healthcould be among the ‘best buys’ for broader economic
development and societal well-being.” Putting afigure on it, the World Economic Forum’s Insights
Report on Closing the Women’s Health Gap has
projected that “investments addressing the women’s
health gap could potentially boost the global
economy by $1 trillion annually by 2040.”
There’s a lot to fix, to put it mildly. But with so many
issues at every point of interaction between womenand our healthcare systems, where do we start to
tackle them?

From an economic perspective, lower productivity atwork is often the first casualty of poor health outcomesfor women. For example, according to a study
published in the British Medical Journal, while 13.8
percent of women reported being absent from work
during their period, a massive 80.7 percent said thatthey attended but were less productive as a result.
Sick days can also put a dent in people’s paychecks
and career plans. A US-based study found that workers
suffering with chronic pain lost 10.3 working days on
average each year compared with 2.8 days for theirpeers, while a survey of employers’ reasons for
not promoting employees revealed that 49 percent
were less likely to advance those who took too manysick days.
Finally, with many women’s menopause symptoms
leaving them less able to cope at work, one in four
consider leaving, and one in 10 actually do. Research
has suggested that the effects of perimenopause andmenopause are costing UK businesses 14 million
working days per year, the equivalent of £1.88 billion
in lost productivity. Meanwhile, the more womenthat go off sick, the more pressure is piled onto thehealthcare system.

In addition toexperiencing
stigma, shame,and judgment,
many womenfeel sidelined,
unsupported, andeven patronizedby the medical
profession.
Redesigning healthcare with women in mind

9

Doubling down on equity

With this in mind, we have outlined
the priorities for change and theactions required to begin theprocess of redesigning healthcare
systems with women in mindaround six themes.
Shaping the public health agenda
Increase public health advocacy to raise awarenessaround women’s health.
This needs governments to put women’s healthon—and higher up—the political agenda and target
sources of stigma and bias around women’s health in
the general population. As we have referenced, theUK government has taken steps in this direction. In
2022, it published the Women’s Health Strategy for
England, outlining its ambitions and actions over a
10-year period to improve the health and well-beingof women and girls. Based on input from more than
100,000 individuals and more than 400 organizations
and experts in healthcare, it reflects critical issues
across each stage of a woman’s life course, fromdisparities in health outcomes to the need for more
women-based research, as outlined in this report.
At the same time, patient advisory groups (PAGs)
and policymakers should work together to weave
compelling communications about novel women’s
health solutions and how they are improving outcomesfor women, not only in terms of their health, but also
psychologically and economically. PAGs can play aconnecting role across the ecosystem to bring all
relevant stakeholders together to share women’s
experiences of the healthcare system, engage, andfeel empowered to collaborate on solutions.

Overhauling medical education
Expand the medical curriculum to cover female andwomen’s health topics adequately and eliminate
sources of bias.
This effort must be two-fold:
Educating medical professionals. At the policy level,
this means embedding women’s health in national
school curriculums to build up knowledge andunderstanding at a young age, and the same must be
done in higher education settings—in much moredetail—so that the medical profession is armed with
scientific and social knowledge relating to female andwomen’s health and knowledge and skills gaps for
medical professionals who are already qualified canbe bridged. As part of the Women’s Health Strategy
for England referenced above, specific teaching andassessments on women’s health will become mandatory in medical training.
Educating patients. With the right policies in place,female and women patients will benefit from having
more useful information at their fingertips about thediseases and conditions that are likely to affect themat all relevant life stages. New technologies andsolutions that can offer help to women in a moreaccessible, less invasive way should also be included
on the curriculum. One example is The Femedic, a
health platform dedicated to women. Offering
education, advice, and information, it is intended
to complement professional health advice.
Finally, the importance of listening, an empathetic
approach, and training in psychosocial skills cannot
be overstated. Healthcare professionals should
understand how their own social markers—includingclass, race, ethnicity, and sexual orientation as well as
gender and biological sex—have the potential toinfluence their interactions with patients and be able
to adjust their behaviors accordingly. Dealing with theemotional aspect of the patient relationship sensitively
is just as important as the medical aspect (if not moreso) and should be included as a core element of
medical training.

Redesigning healthcare with women in mind

10

Raising the stakes on researchand development

Building women-centric
integrated care pathways

Increase the volume of clinical and policy research
trials on female and women’s health conditions, andensure fair gender representation in all trials.

Create care pathways that are accessible and easy forpatients to navigate, covering all patient touchpoints.

First, this requires pharmaceutical companies toensure that all sexes and genders are represented in
the development of any new drugs and therapies,
for example, by including more women in clinicalstudies and trials and carrying out more research into
female-specific conditions and the impact of othergeneral health conditions on women.
But it doesn’t end there. We know that underneaththe surface-level problem of not enough womenbeing included in trials, women of color are evenmore systematically excluded. In the United States,
Congress commissioned a report as a means ofsurfacing and addressing this intersectionality,
which includes policies, programs, and projects
aimed at increasing the inclusion of these groups inclinical research, and a set of recommendations toboost participation.
Academic institutions can also promote knowledge
sharing, dialog, and collaboration on new solutions
for women’s health by establishing interdisciplinary
forums, partnerships, and alliances. One example is
the University of Oxford’s Research Alliance on
Women’s Health. This strategic partnership between
the university and Bayer HealthCare is focused on
researching gynecological therapies and discovering
new treatment options for endometriosis and uterine
fibroids. Another is the EU’s Finding Endometriosis
using Machine Learning (FEMaLe) project, part of theUnion’s funding program for research and innovation.
This has brought a coalition of 17 partners from nine
European countries together to develop a personalized
model for early risk prediction, prevention, andintervention for people with endometriosis.

Enabling policies are the first step here. By building
a public health infrastructure that is simple andstraightforward for women to access and use—for example, by ensuring sanitary materials,
contraception, and sexual and reproductive healthservices are funded properly and readily available—
girls and women will have more control over theirown health.

“We live in a world where wehave the technology alreadyin our hands to eliminate
barriers to care access, but
we still see unacceptablegaps in health outcomesfor women. We need acommitted eﬀort to adopt
digital health at scale if wewant to expand women’s
participation in clinicalresearch, learn more about
their responses to therapy,
and deliver personalizedcare pathways that taketheir unique experiences
into account.”
Dan Vahdat, CEO and Founder, Huma

Redesigning healthcare with women in mind11

In addition, building convenience into the systemthrough such initiatives assumes even more
importance when we consider that women are not
only more likely to assume the burden of unpaid
work and care than men, they also struggle to put
themselves first when it comes to health and wellbeing. Community pharmacies can provide a first
touchpoint for women to discuss their health issues
before diagnosis. Virtual clinics, as provided by Tia,
a US-based healthcare provider for women, enable
users to get help at home, rather than having toattend a doctor’s surgery or clinic.
Collaboration across different segments of the
medical profession, such as pharmacists and GPs,
can also make sure pathways stay intact wherever
they are needed and that patients are treatedholistically and put at the center of care. For example,
Maven is the largest virtual clinic for women’s andfamily health and through a comprehensive platform
offers continuous holistic care across fertility,
pregnancy, adoption, pediatrics, and menopause.
Other new healthcare companies, such as Maeve,
have the ambition to build a healthcare system thattreats the “whole human” in an integrated way. Maeve
is focused on delivering integrated, tech-enabled,and empathetic care whereby dedicated healthcoaches work alongside an integrated care team(including the likes of GPs, OB-GYNs, physios,therapists, dermatologists, nutritionists, dentists,
acupuncturists, personal trainers, and others) totreat women holistically and concurrently.

“With the ongoing advancesin imaging and generative
AI in healthcare, no matter
which hospital you are at or
who the doctor is, welltrained AI algorithms can
automatically detect
disease earlier withincreasingly high accuracy.
I am excited about how AI
can democratize healthcare
for women by reducing
variability in care andincreasing access to lifesaving treatments.”
Christopher Mansi, CEO and Co-Founder, Viz.ai

Redesigning healthcare with women in mind

12

Getting serious about data
Ensure gender-specific data is collected, regulated,
analyzed, and used in a responsible way across thehealthcare ecosystem.
There are four main areas to address here.
Empowering women to proactively manage theirown health. The rise of wearable technologies andapps such as Clue and Flo, the female health app withmore than 300 million users globally, has given
women better knowledge, control, and agency overtheir own health. This not only is in terms of how theirbody is functioning at a given time, but is also opening
up access to related topics and conditions that might
affect women in the future and encouraging a morepreventive approach to healthcare.
Going beyond the individual. Related to the above
point, these advances have also started to provide
a noticeable uptick in data collection and could be auseful integration point with healthcare systems ateach stage of the process—they can even send
information such as your heartbeat, respiratory rate,
and temperature to a healthcare professional in realtime. For example, Ava, a technology company
dedicated to women’s health, proved the potential
benefit of using tech to advance general health when
it ran clinical trials to determine whether the fertility
data gathered via its tracking bracelets could also be
used to detect COVID-19.

“Nuffield Health has been
campaigning to raiseawareness about the longstanding barriers womenand girls face when it comesto their health and fitness.
Data from our Healthier
Nation Index shows thatwomen are more likely toreport barriers to exercise
than men, which is why wehave launched Move
Together, an initiative thatoﬀers free exercise classes
to girls across the UK.”
Davina Deniszczyc, Medical Director,
Nuffield Health

Putting a connecting infrastructure in place. Again,
policy is the key to making data work for the healthcare system and for women. This includes making
electronic health record (EHR) systems—supplied by avariety of vendors—fully interconnected and interoperable so that data flows are uninterrupted and any
woman’s health—including her history, potential flags
for certain diseases, and where comorbidities could
show up—can be managed holistically. For example,
NHS England’s Federated Data Platform (FDP),
operated by Palantir, will aim
to connect data at scale in a safe and secureenvironment across the health service to deliver
more responsive services and more joined uppatient care and make it easier for healthcare staff.
Building in security and protection. In addition toensuring that data is high quality, secure, usable,
reliable, and compliant with all required laws andregulations, it’s crucial that data is used only topromote women’s health and well-being, that its
use doesn’t place women at risk in any way, andthat any fears around trust, identity, privacy, andindividual security can be overcome.

Redesigning healthcare with women in mind

13

Accelerating investment
Increase funding across the ecosystem for academic
research, product research and development, andconsumer health solutions.
Policy input is vital here to make sure funding for
research and innovation is directed appropriately andproportionately into female- and women-specifichealth conditions as well as developing new businessmodels to create affordable solutions. Academic
institutions should also consider increasing funding,
grants, and special programs to attract more medical
and science research into these areas, particularly
those that are currently underserved. Pharmacompanies also have the resources and influence
to fund more women-specific clinical research.
Last but not least, private investors and investment
funds can make a real difference to women’s health.
Venture capital funding for women-focused healthstart-ups was previously sitting at less than $100
million. However, women’s health investment hasflourished in recent years, experiencing a 314 percent
increase compared with a 28 percent increase in
overall healthcare investment. One reason could
be that more women founders and investors are
becoming active in the market. Of women’s heath
companies, 76 percent have a female founder,
which is three times higher than the overall innovation
ecosystem. As Jessica Federer, the head of a New
York investment company, told the Financial Times:“Every human on the planet is the product ofwomen’s health. … Waiting on male investors toinvest in [it] clearly hasn’t been working.”“Investing in research andbusiness in women’s healthis a mandate that can shift
healthcare outcomes,
reduce economic burden,
promote gender equality,
and create economic
opportunities. It is a
strategic investment andcommitment that creates
more productive andhealthier societies.”
Carolee Lee, CEO & Founder,
Women’s Health Access Matters (WHAM)

Redesigning healthcare with women in mind

14

Making it happen: for everyone, by everyone

As with all complex whole-ofsociety issues, there’s no way for
any individual or group to solve thison their own. So although various
stakeholders can (and must) playtheir own hand, the real power—
and real transformation—will comefrom deep-rooted, continuous
collaboration across all aspects of
the health ecosystem. The needs
are clear:
Rethinking what equitable healthcare means:— Understanding what drives worse health outcomesfor women, and recognizing the combined impactof all social determinants of health, in addition tobiological sex and genderAnd ultimately:
Changing the mindset everywhere that mattersfrom “women as the exception to the Reference Man
rule” to the rightful “women as 50 percent of the
population worth investing in” and therefore
regenerating healthcare systems so they havetrue equity at their core.
Full regeneration is a tough—and essential—ask. But
it’s possible, especially if done through creativity,community, and collaboration. In the words of Gloria
Steinem, one of the original advocates for women’s
reproductive rights, health, and well-being, “The future
can be what it should be, because we are going to
make it what it should be.”Come and join us.

— Changing the conversation about women’s healthin schools, at home, at work, and in healthcare
settings—and getting society behind this shift— Increasing the representation of women where
it matters
Resyncing all stakeholders around this new mission:— Establishing more well-funded and highly visible
women’s health programs and infrastructure thatare based on women’s experiences, expertise,and insights and joining these together acrosseducational settings, workplaces, and thehealthcare system so they become even more
dynamic forces for change— Setting up the communities and groups thatprovide education, support, encouragement,
and safe spaces wherever they are needed— Supporting, endorsing, and driving action at
the most senior leadership levels in government,
research, and industry

Redesigning healthcare with women in mind

15

About FemTechnology

About Kearney

FemTechnology.org is on a mission to close
the gender data health gap via their flagship
Summit – bringing together corporates,
femtech start-ups, researchers, and clinicians
for a 360-degree perspective on innovationin order to tackle collective pain points inwomen’s health; University Series – scouting
groundbreaking researchers and innovators inwomen’s health to help disseminate their work
to a broader audience and connect them tofunding opportunities; and Guide – aggregating
women’s health solutions to match innovations
directly to women in need and build thefoundational database for future breakthroughs
in women’s health.

Kearney is a leading global management consulting
firm. For nearly 100 years, we have been a trusted
advisor to C-suites, government bodies, and nonprofit
organizations. Our people make us who we are.
Driven to be the difference between a big idea andmaking it happen, we work alongside our clients toregenerate their businesses to create a future thatworks for everyone.
kearney.com

femtechnology.org

For more information, permission to reprint or translate this work,and all other correspondence, please email insight@kearney.com.
A.T. Kearney Korea LLC is a separate and independent legal entity
operating under the Kearney name in Korea. A.T. Kearney operates
in India as A.T. Kearney Limited (Branch Office), a branch office ofA.T. Kearney Limited, a company organized under the laws ofEngland and Wales. © 2024, A.T. Kearney, Inc. All rights reserved.

FemTechnology Summit 2023

ROLE OF THE MEDIA IN
WOMEN'S HEALTH
GenZers who consult social media for healthadvice before turning to their doctor:

73%

44%

33%

Question tackled:More than 84% of women feel that their healthcare
professionals were not listening to them. This comes at a
moment in time when Social Media is increasingly relied
upon as a source of health information.
How can we use media (social, traditional or otherwise) as
an effective educational tool? And what can be done torestore public faith in clinicians?
IN COLLABORATION WITH

What is The Role of Media in Women’s Health?
As Reported by Danielle Perro, Postdoctoral
Researcher: epidemiology to study period
pain in adolescence and understand both its
causes and impact on chronic pain later inlife.
Context:
In an increasingly digitised society, mostpeople stay up to date with the world aroundthem through social media. It is therefore no
surprise that people do the same to find out
about their world within. Now more thanever, as health care systems continue tostretch beyond their capacity, women needanswers about their bodies, and they needthem quicker than existing health careinfrastructures can provide.
At this year’s FemTechnology Summit in Basel (June 6th & 7th 2023), stakeholders working
at FemTech Startups, Academia, Clinicians and social media influencers, joined forces toconsider current challenges in the way the media is used to supplement women’s healthinformation, and how moving forward, these
could be addressed.
Facilitated by Dr. Mitzi Krockover, key pain
points and questions to be answered wereidentified.
Social media offers a rich hub of women’s
health information and support, yet medical
misinformation is rife on these platforms. As
someone who has personally used social media
to engage and translate my PhD research todifferent audiences, (especially Twitter during
its less turbulent times), extra thought isrequired to ensure that the content is in the first
instance accurate, but importantly, designedwith your audience in mind. With such aplethora of information available online, it canbe challenging for consumers to access robust
health information, especially if possibly lesscredible health information is presented in amore engaging way.
How bad is this problem, and what does this mean for women?

According to a recent study done by Flo Health on
menstrual and reproductive misinformation, 22% of
women aged 18-24 are receiving their sex andreproductive
healthinformation from social
media–however–10% of these women don’t fact checkthrough a second source, to ensure that what they’reseeing is trustworthy and reliable. If you’ve ever done a
deep dive into your own reproductive health questions
on the internet, you may have noticed that it’s not hard
to find a convincing post on social media spreading
inaccurate information. If this information comes fromsomeone with a large following, or a professional
accreditation, it is more challenging to discern factfrom fiction.
As a group, we acknowledged that in our fast-paced
world, many women play multiple roles in society andthe household, which may reduce capacity to seek asecond source, while proposing that this process could be streamlined, and the burden, taken
away from the woman. Could the future of women’s health information dissemination online
look like, as we saw with the COVID-19 pandemic, articles or social media posts flagging anarticle as containing misinformation or information from an untrustworthy source? I think
this is crucial.
A further challenge we encountered was how we better bridge the divide between knowledge
producers and users.
How do we incentivise the production of accurate information online by knowledge
generators?
As mentioned above, women’s health infrastructures within existing health systems are
struggling. As a result of the pandemic, wait times for gynaecological procedures were insome cases, years, (though wait times have improved, they are still too long) and health careprovider (HCP) burnout is on the rise. So, how do we incentivise the creation of engaging
medical communications from leading HCP or researchers in the field? As of now, for many,
it is done in their own time and without additional financial compensation. From personal
experience as a women’s health researcher, science communication and public engagement
still aren’t seen as integral parts of the science life cycle, rather a tick box exercise now
required by some funders. Is it a researchers’ duty (aside from funding body requirements) toengage the public with their research? I would argue yes, but this remains to be discussed by
the research community.
Structurally, there still exists a disconnect between research and health care provisionpriorities and science communication or co-production. With Flo’s report, and mounting
evidence from researchers in the digital health space, it’s clear that women are turning tosocial media for health information. When done correctly, disseminating information, andengaging with the public on social media can be mutually beneficial for the user and HCP
alike. Women get access to evidence based information, and HCP/researchers increase theawareness and impact of their work. The ultimate question though, is how do we fund thistype of work, and how does it become prioritised in the women’s health landscape?
What does the future of women’s health and the media look like?
For online communications to be as
beneficial a supplement to health care as
possible, this work must be accessible,
patient-centred, and crucially, accurate.
Particularly as we see a stark move towards
digital health platforms and FemTechsolutions, these factors are even more
important. From this workshop, Dr
Krockover was ‘energised by the depth of
discussion and breadth of participant
backgrounds’ at the table to envisage thisnew future together. By canvassing thecurrent situation, as well as identifying theneed for health literacy, a solid foundation
for considering next steps was laid. To
action these, Mitzi outlined some necessary
advancements:
1. A consensus on what is classified as credible information and sources, and from there;
2. Technology to cull through the overwhelming amount of new data generated daily,
considering the consumer’s educational background.
3. Increased health literacy, and possible guidelines for women to help them becomeaware of the credibility of information and the motivations of those providing it.
It’s clear that a movement is needed, and perhaps it’s one that we’re already a part of, with all
stakeholders at the table. If tech will be playing such a massive part of our health knowledge,
literacy and care, infrastructure needs to be put in place to ensure that women are able toaccess and understand high quality health information on social media. On the other hand,and importantly, we must consider where our health information is coming from online. With
the momentum from the Summit, the impactof these conversations has only just begun.
Leveraging this with the diverse experiences,
resources, and dedication from attendees, itwill be promising to see how in a year’s time,
we’ve been able to further its impact.
Additional perspectives:
Daphne Petrich - Senior Business Development
Manager @HelloBetterWe discussed the topic of ad censorship, which is a timely topic given the CIJ's recent legal complaint(Sign the petition here)
We discussed how women are taking charge of their health due to systematic misdiagnoses anddisregarded pain. Trust is at an all-time low, especially for vaginal discomfort (BV, vaginismus etc.)
and autoimmune diseases. We highlighted the power of social media in democratizing access toscience. Women can make sense of their symptoms and turn to the best specialists to 'optimize' theirhealth outcomes. At the same time, consuming health information in a bite-size format is limiting andpotentially dangerous. We discussed how different stakeholders could protect us from misinformation.

Lily Pemberton - Women’s Health Physician
I think one of the recurrent themes of our workshop
was that women often don’t feel heard in the
medical system. Women often put themselves lastwhen it comes to their health needs, and when they
do make it to the healthcare system, their symptoms
are often ignored or dismissed. This ismultifactorial and has to do with a lack of physician
education and awareness, a historical lack of
information regarding women’s specific healthissues and natural history of disease in women, andstereotypes and gender biases that lead physicians
to ignore or try to “normalize” women’s symptoms
as part of “just being a woman”. My personal
solution as a physician is to keep myself informed
about emerging evidence in women’s health, as wellas practicing empathy and “believing” my patients
when they feel like something is wrong. I think a large part of the solution in addressing women’s
health is to first teach student physicians and other healthcare workers about these historical biases inmedicine against women, and to build on the growing emerging knowledge regarding women’s
differences in physiology. I think the “male mode;” as normal has existed for far too long, and theteaching as well as the practice of medicine need to be adjusted.
Kathryn King - Founder @Bloody Honest
It certainly shocked me to learn just how poor
education is on Women's Health when I firststarted having these discussions. Some of themost common questions I get on TikTok is"Where is the vagina?" and "How many holes
do I have?". It's hard to tell how old some ofthese young people are but I would guessaround 11-14.
I think while there are so many amazing people
doing amazing work in the area, it's so easy forpeople who have knowledge and expertise notto realise just how low the bar is for health literacy.
I don't have an academic or clinical background so some people might wonder what gives me the rightto talk about it. In reality, it's because I'm not a clinician or an academic that helps me communicate
with the young people who so desperately need the discussions.
I am incredibly conscious of the damage misinformation can cause, and make every effort to be as
responsible with my platform as possible. I tend to stick to personal experience or what's considered'common knowledge' as far as possible; or ensure I cite anything further and will often discuss topics
as theory vs fact. It can feel impossible, even for people who have some knowledge on the subject, toknow where and how to access credible, reliable information.
It's imperative for the advancement of women's health literacy that there is constructive collaboration
between media and experts, built on mutual respect and core understanding of the needs of the public.
Written by Danielle Perro, BMSc, PhD
Illustrations by Kryza Talavera
Edited by Oriana Kraft and Emma Ricci-De Lucca

THE EVOLUTION OF
FEMTECHNOLOGY SUMMIT
2021

THESIS IN MEDICINE @

2022

2023
IN COLLABORATION WITH

FEMTECHNOLOGY SUMMIT 2021
Our very First Edition had more than 700 online attendees

FEMTECHNOLOGY SUMMIT 2022
1500+ virtual attendees from more than 60 different countries

FEMTECHNOLOGYSUMMIT 2023
Over 140 in-person
attendees from morethan 6 countries
and in 8+ sectors of
women's health