As a physician at Duke, I often saw how women, especially those juggling chronic illness, caregiving, and limited healthcare access, faced delays in getting the right care. What stood out wasn’t just the complexity of their conditions, but how predictable the barriers were.
Women face unique challenges in getting timely access to the care they need. Many care options are simply inconvenient and often do not meet patients where they are. For example, forcing a busy working mom to take the day off work, driving 30 minutes for a routine screening can be a challenge if having to juggle a 9-5 and childcare too. Many women are caregivers for aging parents or children, compounding the challenge of taking care of oneself.
To make health more equitable, women require convenient options to engage in their health and readily participate in research. Recently, a landmark 40-year study of beta-blockers, one of the most common medications prescribed, demonstrated that adverse effects on women, when taken after specific types of heart attacks. This flew in the face of what I was taught in medical school, though at that time there weren’t enough studies with women participants and the information just wasn’t available. For years, women have been prescribed these medications, based on study designs that didn’t adequately represent them.
It’s not just that women are underdiagnosed or left out of research; it’s that we’remissing a massive opportunity to advance health by elevating options for women. Women are the most frequent healthcare decision makers, but also the longest consumers of healthcare (i.e. women live longer than men!) in the economy. While women account for 80% of healthcare decisions, they also make up 65% of the healthcare workforce. They experience more chronic disease, and spend more out-of-pocket, not including maternity costs. They use more prescriptions, attend more appointments, and shape family health behavior.
If you’re building a product, launching a trial, or setting a research agenda, the reality is simple: You’re already in the business of women’shealth, whether you know it or not.
WOMEN’S HEALTH IS MORE THAN BIKINI MEDICINE
For too long, “women’s health” has been conventionally categorized by the body parts covered by a bikini—reproductive care, breast cancer screenings, and obstetrics related topics. This is instead of what it truly involves: the whole body. Several studies show women are consistently and disproportionately affected by stroke, cardiovascular disease, neurocognitive disorders such as dementia, and more. Women are the cornerstone of the entire healthcare market,whichcan boost the global economy $1 trillion annually by 2040. Bikini medicine has left care gaps in everything from heart disease to chronic pain.
On the biopharma side, just 4% of R&D spending targets medical research specific to women. And yet in 2024, female-focused startups received only 8.5% of digital health funding, down from nearly 15% in 2020. This isn’t about a lack of innovation. It’s about a lack of prioritization.
WHEN WOMEN ARE LEFT OUT, EVERYONE PAYS
There are real costs when women are left out of the data:
- Clinical risk: Women are twice as likely to experience side effects and we aren’t sure why. Potentially, it’s because trials skew male.
- Economic drag: Women spend 25% more of their lives in poor health compared to men. That results in billions in lost productivity and missed potential.
- Reputational fallout: In a consumer-driven world, building products that don’t work well for half the population is a fast way to lose trust—and market share.
Getting women into research is not a nice-to-have. It’s critical for safety, quality, and return on investment, and to develop therapies that work well for over half of the people they are prescribed to.
CLOSING THE GAP COULD UNLOCK $1 TRILLION A YEAR
McKinsey estimates that improving outcomes for women could add $1 trillion to the global economy annually, by 2040. That’s not wishful thinking. It’s rooted in simple interventions—better diagnosis, smarter data, faster access to care.
Consider this: Half of all women in the U.S. Half of all women in the U.S. each year skip or delay care, often due to costs, scheduling issues, or a lack of trust in the system. Couple this with clinical research historically, and there is less substantial women’s data available to train AI models powering the future of care, even though women take more medications and manage more chronic conditions.
This is where the opportunity lies. Build for the real world, and you build a better business.
DESIGNING FOR WOMEN DOESN’T MEAN EXCLUDING OTHERS
There’s a common fear that focusing on women somehow limits your market. But the opposite is true. Solutions that meet women’s needs—like care navigation, chronic disease support, and flexible benefits—solve for a broader population, too.
What makes women’s health complex is also what makes it valuable. If your product or trial can work for women across life stages, it can be used to inspire solutions for anyone.
WHAT SHOULD HAPPEN NEXT
If we want to change the trajectory of women’s health, we need to:
- Make convenient options for women to improve access to resources and research participation.
- Fund more companies prioritizing women in their design and leadership.
- Follow the January 2025 FDA guidance for trials and datasets to reflect real-world populations, like menopausal status and menstrual cycles.
- Expand benefits that meet women’s needs beyond reproductive care.
- Build tools that understand female physiology and behavioral patterns.
This isn’t just a moral imperative. It’s a competitive one.
LET’S SHIFT THE CONVERSATION
Equity in healthcare is an imperative focus of health innovation and personal to many of us, but there’s a business case that’s been hiding in plain sight. Women are the health economy’s chief consumers, workers, and unpaid labor force. Failing to invest in women is failing to invest in the market.
Joy Bhosai, MD MPH is founder and CEO of Pluto Health. Jessica Federer, MPH is the managing director of the Women’s Health Fund, and an investor in Pluto Health