Closing The $1 Trillion Women’s Health Gap with Lucy Pérez
about the episode
In this episode of Innovate and Elevate, Sharon welcomes Lucy Pérez, a Senior Partner at McKinsey & Company and Coleader of the McKinsey Health Institute. Lucy is also coauthor of the groundbreaking report, "Closing The Women's Health Gap: A $1 Trillion Opportunity to Improve Lives and Economies," copublished with the World Economic Forum. Sharon and Lucy discuss the report’s key findings and the significant economic and social benefits of closing the women's health gap.
Lucy shares that closing the women’s health gap could add an astounding $1 trillion to the global GDP annually. This economic boost would come from healthier women having fewer missed workdays, increased productivity, and less time spent on unpaid caregiving duties. She highlights that women, despite living longer than men, spend more time in poor health, particularly during their most productive years (ages 20-60), which has considerable economic implications.
A major challenge in addressing women's health is the shocking underinvestment in research. Currently, only 1-2% of R&D dollars are dedicated to women's health issues, excluding cancers. Lucy emphasizes the need for increased funding and better understanding of sex-based differences in medical research. Conditions like cardiovascular disease and autoimmune diseases often present differently in women, necessitating tailored approaches to diagnosis and treatment.
Lucy provides actionable advice for how individuals can close the women’s health gap, including ways to be proactive in healthcare interactions, raise awareness about women's health issues, and support initiatives aimed at closing the health gap. She also underscores the importance of leveraging real-world data to drive innovation and improve health outcomes, advocating for strategic partnerships and increased funding to address health inequities.
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“Everyone needs to understand there are sex-based health differences. Women’s health is more than those conditions that are unique to sexual and reproductive health.”
About Lucy Pérez
Lucy Pérez, a Senior Partner at McKinsey & Company and Coleader of the McKinsey Health Institute. Lucy has over 15 years of experience advising CEOs and top teams at leading global pharma, biotech, and life science organizations on growth, strategy, innovation, sustainability, and organizational transformation. In addition to her client service, Lucy sponsors McKinsey & Company’s Hispanic and Latino Network in North America. Before joining McKinsey, Lucy was a research fellow at a cancer center, where she was involved in the development of novel treatments for solid tumors. Lucy received her Ph.D. in Chemistry and her Bachelor of Arts from Harvard University.
Episode Outline
(02:13) What Is The Business Case For Investing In Women's Health?
(07:50) Understanding Sex-Based Health Differences
(11:43) When Women Are Healthier, Everyone Benefits
(18:06) Opportunities for Women's Health Research, Development & Funding
(25:01) How Can We Contribute to Closing The Women's Health Gap?
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Sharon Kedar 00:02
Behind every pioneering idea, method, and device is a fellow human or humans. A trailblazer who is daring enough to ask the questions that push the boundaries and make the impossible possible. I'm Sharon Kedar, co-founder of Northpond Ventures, a multi-billion-dollar science-driven venture capital firm, and the host of "Innovate and Elevate." In each episode, we'll have candid, in-depth conversations with top doctors, scientists, and innovators about leading-edge discoveries and how they impact our lives. Season one focuses on women's health, with the aim of helping women lead our healthiest lives. You'll hear from leading experts such as Dr. Kathryn Rexrode, Division Chief, Women's Health at Harvard's Brigham Hospital. It's time for all of us to innovate and elevate.
Sharon Kedar 00:53
Today we have Lucy Pérez on the podcast. Lucy is a Senior Partner at McKinsey & Company, an affiliated leader of the McKinsey Health Institute, where she leads the institute's work on health equity. Lucy has over 15 years of experience advising CEOs and top teams at leading pharma, biotech, and life science organizations globally on growth, strategy, innovation, sustainability, and organizational transformation.
Sharon Kedar 01:21
She leads McKinsey's women's health effort globally and is the author of the January 2024 report, "Closing The Women's Health Gap: A $1 Trillion Opportunity to Improve Lives and Economies," published by the McKinsey Health Institute, in partnership with the World Economic Forum. As a former cancer researcher at Memorial Sloan Kettering, Lucy brings strong technical background to her work, helping organizations solve their most pressing challenges. Lucy received both her PhD in Chemistry, as well as her Bachelor of Arts from Harvard University. Lucy, welcome to the podcast.
Lucy Pérez 02:02
Sharon, thank you so much for having me here. Really excited to spend some time with you.
Sharon Kedar 02:13
Anyone who writes and publishes a report that says that closing the women's health gap is a $1 trillion opportunity is a friend of mine. If you could talk about that big, hairy, audacious goal to write that report, how did you even come to that? A little bit about what got you here to this incredible place that you sit today.
Lucy Pérez 02:34
Yeah, happy to chat about that. Health has always been something that has been really a big interest of mine, whether it's because, you know, watching my great-grandmother when I was a child struggle recovering from stroke. And then as a high school student, I volunteered at a local hospital in Puerto Rico. You realize health is foundational to everything that we do. I often like talking about when you look at the improvements in economic output over the last 200 years in the world, you can correlate the biggest improvements in that to improvements in human health that make that possible. And so through all the work that I've been doing in the healthcare space, health equity has been front and center. And this idea that everyone should have access to the best innovation to lead their best, healthier lives.
Lucy Pérez 03:22
But too often, you know, you see these observations, or you hear the stories from your friends or family members about women not being heard in the health system and just having different questions. And it's something that, you know, within the McKinsey Life Sciences Practice, we've been looking at for a long time this idea of, like, really needing to have a better understanding of women's health outcomes. Because there's a lot of myths around them. And most people tend to think that because women live longer, that must mean that they're healthier.
Lucy Pérez 03:53
And so last year, we had an outreach from the World Economic Forum around exploring this opportunity to say, what is the economic impact of investing in women's health? And we thought that was a really exciting opportunity, because indeed, it's something we had been looking at for several years. And they had brought together this coalition of more than 40 organizations. And so anytime you're tackling, like, a big, meaty topic like this, actually having the right set of partners around you, to drive the change that it requires, it's really necessary and essential. So we thought this was a great opportunity of bringing all these people together and really answer that question of, what's the business case for women's health? Because it felt like, I mean, it wasn't clear. You would think in 2023 this should be a done deal when we're talking about, you know, slightly more than half of the world's population. And so that was the motivation to get in there and try to answer the question around that positive economic impact beyond the health impact around investing in women's health.
Sharon Kedar 04:54
That's beautiful. And to your point, I think the business case is essential. I don't think we'll get anywhere without the business case. So if you could just unpack some of the key findings about why should we care business case-wise about women's health.
Lucy Pérez 05:13
So let's talk about why should we care, right, about women's health. I mentioned this concept, this fact, women on average live longer than men. But one of the things most people don't realize is that they spend more time in poor health than men do. And people often think that this time spent in poor health happens at the end of life, that it goes hand in hand with this idea that women live longer than men. But that was one of the big findings from our report, is that, actually, the majority of this health gap of time spent in poor health happens during women's prime working years, between ages 20 to 60. And so because it's happening during women's prime working years, it has huge economic implications. And so the title of the report is this $1 trillion opportunity, which, by the way, it's an annual opportunity, of how much more can we grow the global GDP each year by closing the women's health gap. And so it comes from four different places.
Lucy Pérez 06:14
First and foremost is because we're saying, "Let's give women more healthy days back so that they can show up to work more days." So it's a reduction in absenteeism. The second part of it is fewer early deaths, being able to keep women in better health longer. The third part of it is increased productivity. We all know that we show up to work on days where we're not feeling 100%. And those days we typically are unable to give the 100%. So imagine having more days of being in full health. And then, finally, the fourth part is about being able to give women more days where they don't have to be doing unpaid caregiving. We know that women shoulder the majority of the responsibilities for caregiving of, you know, family members, friends in an unpaid capacity that takes them, again, out of the workplace.
Lucy Pérez 07:07
And so when you take these four buckets together, they total at least a trillion dollars. And I say at least because one of the big findings that we had is also how much data we're missing and how much undercounting there is when it comes to women's health. And so you bring all those together and, I mean, that's a big number. But I oftentimes like also shining a light on what does it mean for the average woman, you know, you, me. We're talking, on average, it's seven more healthy days every year per woman if we were to close the health gap. So those are pretty significant numbers.
Sharon Kedar 07:50
Those are huge numbers. Clearly, it's a mandate to do better regardless if we know the why. But it's fascinating, and I wonder what the why is. And maybe that'll come over the future years. If it's when we are 20 to 60 years old, why is that the case?
Lucy Pérez 08:09
Yeah, so there's four main reasons that we see that are driving this gap. The first one is actually the limited understanding that we have of sex-based differences. Because oftentimes, again, we simplify women's health to just be those conditions that are unique to women. But the reality is that women's health is that and conditions that impact women differently. Like, for example, if we think of cardiovascular disease, you know, how a heart attack may manifest can look different in a man versus a woman. But it's also those conditions that impact women disproportionately, like many immunological conditions, where like 80% of the patients suffering from them are women.
Lucy Pérez 08:53
And so when you bring that all together, what you see is that, actually, the women's disease burden, the majority of it actually comes from conditions that impact both men and women, but that impact men and women differently or disproportionately. When you try to see, well, how much do we know about those sex-based differences that lie at the heart of why women are having worse outcomes in many instances, we actually don't know a lot. We need to investigate those further and really recognize it's not just human biology. We need to recognize male versus female biology being quite different, beyond reproductive organs. So that's reason number one.
Sharon Kedar 09:35
When you talk about sex-based differences and needing to catch up, curious your perspectives on how we catch up. And do people even really care?
Lucy Pérez 09:46
I think there's, for example, a big opportunity in redesigning curriculum. Because especially here, where we already know what some of those differences are, how are we training the next generation of physicians, and those in the healthcare system, and those that are currently in, right, to understand how these differences show up, so that they can provide the best possible care to their patients? Then I get really excited about some of the opportunities now. When we think about the data that's available, the technology that's available, if you think about clinical decision support tools that are so pervasive, how can those help that provider when the patient walks in to have that reminder, that nudge? Given the sex, the gender of that patient that's coming in, how should I be thinking? What are the questions that are top of mind? What may be the way the symptoms manifest? So there's a part around that.
Lucy Pérez 10:41
It is true, women were not in clinical trials until 1993. But now we have a lot of evidence, real-world evidence that can be mined, that can be interrogated as well, to augment those gaps that existed, because indeed, women were not in the clinical trials, that we have to get in there and be asking these questions so that then we can design those sex-appropriate care protocols. So that when a woman shows up to the ER with symptoms of a heart attack that may look more like indigestion, and by the way, that's what ends up happening, you know, many times, and why women die at a higher rate from heart attacks than men do, that physician that is seeing her has that moment to be like, "Actually, let me take a step back and think about what other tests should I be running and not assume that this is indigestion." So there's multiple plays that need to come together to improve those outcomes.
Sharon Kedar 11:43
If you could touch on what you learned in the report in terms of the implications of that gap, would love to hear that. And then would also love hear what you think the advice is for women today who read this. Because you read this, and it's a huge opportunity, but it's also a situation now where you're walking into a bit of a black box. And I just don't think women know that.
Lucy Pérez 12:09
There's a ton of misconceptions or myths when it comes to women's health. And so for me, personally, and as I think of the large team involved in driving this research, first and foremost is we do need to raise that awareness and education. And really make sure that everyone, men, women, young, old, everyone understands that there are sex-based differences. That women's health is more than those conditions that are unique to women in sexual and reproductive health, which is what normally just gets concentrated to that. So that's number one. Hand in hand with that, like, I think one of the big callouts from the report is how we need to increase funding and investment so that we actually are asking those questions and have a better understanding of female biology. Because, by the way, when we have that better understanding of those sex-based differences, everyone benefits.
Lucy Pérez 13:05
I mentioned to you before, in the data that we saw, there are plenty of instances as well where men have worse outcomes, and that is happening because we are not trying to understand sex-based differences. So by understanding them, everyone stands to benefit. And so in order to be able to know what those are, we need to be collecting the right data. We need to be thinking about how we're designing those experiments that enables us to ask the questions. And then that we pull it through, that we are developing care protocols that take into account those differences. Because again, now with the technology that's at our disposal, it becomes that much easier to do that. So that's a big part of it. And so I would say, as I think about the implications, I hope what a lot of the audience takes away is like, that business case for investment is very clear. That trillion-dollar opportunity, and by the way, that's the low end of the spectrum. We took very conservative assumptions in doing this work. And that doesn't even include what are the market opportunities from developing new products.
Lucy Pérez 14:11
Let's talk a condition like endometriosis. This is a condition that impacts 1 in 10 women. Those are, by the way, the same numbers as for diabetes. About 1 in 10 women have diabetes. So you look at diabetes and there are a whole range of different drugs and other solutions that are available in the marketplace, and there's a very healthy pipeline of clinical development. Over 500 assets are right now being developed to drive better outcomes for diabetic patients. Over 500. Endometriosis, a condition that impacts pretty much the same number of women, like 1 in 10, we're talking about on the order of two dozen, just over 20 assets in clinical development. And this is a condition that can be quite debilitating. It can take you out of the workforce, and we just don't have good solutions. The better solutions that exist now are asking a woman to choose between fertility or pain.
Lucy Pérez 15:12
So when you do the math and say if we had a drug that could be taken that could help that woman suffering from endometriosis, manage her symptoms, optimally cure her, we're talking about a huge market potential. Because again, at the end of the day, your market is number of patients that would stand to benefit and the value associated with this. Because this is such, you know, something that impacts so many women, this is a market that could easily, frankly, be even bigger than the oncology market, as an example.
Sharon Kedar 15:43
I think your points are spot on, Lucy, when it comes to endometriosis. I completely agree with you. I don't think it's acceptable that surgery is the current diagnostic, and it takes about 10 years for a woman on average to get diagnosed. But this is not new information, so I'm just curious what the catalyst might be to actually close that gap.
Lucy Pérez 16:05
You say it is not new information that 1 in 10 women suffer from endometriosis, but the reality is the majority of the public or medical school students, right, or professionals, if you were to up poll them on what is the prevalence of the disease, they would probably give you a much lower rate than what it is. So there's an under-appreciation for how prevalent endometriosis is. When you think about just the basic science and the disease understanding, it's also very immature. Until recently, we thought there was basically one disease pathway. We're now beginning to understand there's more complexity to it. So we just haven't spent as much time, energy, resources in understanding the basics of the disease.
Lucy Pérez 16:51
While there have been, and still are, several life sciences companies that are making progress developing new solutions in this space, in the US it requires a laparoscopic surgical intervention to be diagnosed. So that's one of the requirements to participate in a clinical trial. Guess what? It becomes really, really hard to recruit for a clinical trial when you're telling women, who may be very interested in participating, that that is a requirement. That participation in the trial may require not just one, but multiple of these procedures.
Lucy Pérez 17:24
So all of these things together, again, speak to what needs to happen. We need to make sure there's the understanding of, how big this is. The understanding of the disease itself. How are we doing more investment in the basic science as well, building better models of disease, and leveraging other diagnostic technologies that become less burdensome, that make it easier to drive, for example, more clinical trial participation and reduce that time to diagnosis? I mean, 10 years to diagnose something on average that 1 in 10 women have, I find it shocking.
Sharon Kedar 18:06
What I hear you saying is that there's an awareness gap, that obviously you're doing tremendous work to fill, and that part of it is raising the awareness. And then I know you touched on some of this in the report, I would love to hear who's actually going to do the research and fund this and start to shift the paradigm?
Lucy Pérez 18:25
So let's put it in perspective. When you look at R&D dollars that are being spent today, it's on the order of 1 to 2% of R&D dollars are going towards women's health, when you take the more narrow definition of conditions that are unique to women. This is excluding women's cancers. If you look at women's cancers, then that number is another 2% or so. But then you start saying, let's look at budgets, for example, NIH budget for cardiovascular disease, and what portion of that is looking at sex-based differences?
Lucy Pérez 19:00
Because, by the way, heart disease is the number one killer of women in the US. But the portion of those dollars that's going towards, understanding sex-based differences is still very small. And so it all begins through how are we increasing the funding availability so that those researchers that, whether they're in academia, in a community setting, in industry, are also being able to put more energy behind asking these questions of what's driving this disease, the differences in outcomes that we see? So to me, that is, in a way, foundational.
Sharon Kedar 19:38
Lucy, you said 1 to 2% of research dollars goes to women's health-specific diseases that are not cancer in women. When we talk about that 1 to 2%, what is the data set? So is that of pharma dollars? Does that include government dollars? Just curious.
Lucy Pérez 19:56
So this is looking at clinical development dollars. So that is a mix of both what's happening from the private sector, as well as from the public sector.
Sharon Kedar 20:06
That is a very low number.
Lucy Pérez 20:09
It is an extremely low number. Yes. And this is, again, why, to me, that is one of the foundational elements. We need to grow that number because there's a lot of unmet need that is being unaddressed, because we're not investing in understanding conditions like endometriosis or polycystic ovarian syndrome, another one that actually has very high prevalence. Look at maternal death rates in this country for some groups like African-American women. We need to do more to improve women's health also within those conditions that are unique to women. Then there's the piece around how are we leveraging the data?
Lucy Pérez 20:48
Indeed, there's a lot of drugs, surgical interventions and others that are in the market today that were developed prior to 1993. And so they were developed without taking into account women in those trials. But the good news, and I tend to be an optimist, is those products, those interventions have been deployed in women. And we now have the real-world data. And so how are we using that data to understand, and deploy then, care protocols that lead to better outcomes for all types of population? That's the piece that we now need to make sure we also make more progress on as well, because I don't see us going back to rerun clinical trials for everything. But we do have a treasure trove of real-world data that we can be leveraging differently.
Sharon Kedar 21:38
I love that. I think that that is gonna be part of unlocking the answer, is data matters here. And understanding women's biology specific to certain diseases. I wonder, and maybe we'll just see how this unfolds, whether it's gonna be more public dollars, private dollars, a combination of the two. But you'd imagine that this is pretty low-hanging fruit, right, because it has been so underinvested, that for astute, business-oriented people who can develop the business case, that this could be quite compelling. But I'm just curious your perspective on whether you think it's public/private dollars, sort of all of the above, depends on the disease?
Lucy Pérez 22:16
All of the above is always, I feel like the answer when you're tackling thorny topics like this, one where, you know, highly complex. Everyone has a role to play. The public sector, the private sector, the public. And so it is really important that in doing this, that, again, we're communicating, we're raising awareness for everyone, because everyone really has a role to play here. So I think that the basic science funding, we'll continue to see probably more of a government funding doing a larger share of that, as has been historically the pattern. What I think is also really interesting here is that this is a global priority.
Lucy Pérez 22:52
When we launched this report in Davos in January, there was also the launch of the Global Alliance for Women's Health, bringing stakeholders together, different geographies, public and private sector hand in hand. Because again, it is this recognition that health and economy go hand in hand. And that there is not only this productivity opportunity that we're talking about, that GDP growth, that it's there, but it's also all these different new markets that could be had. We touched on endometriosis, but there are so many more. For example, if we're improving diagnostics that are available. Because we know for so many conditions, women take longer to get diagnosed or to get to the accurate diagnosis. That is a huge opportunity.
Lucy Pérez 23:37
Then there's this idea of all these different conditions where we don't have good drugs or surgical tools or other interventions that, again, create attractive investment opportunity. But we need to have the data in hand that helps those who want to make that investment derisk that investment. Because, at the end of the day, investors have choices, and they want to try to be solving for that high return on their investment. And so having the data in hand that allows them to more confidently derisk and make a bet on something that's a big market opportunity is a big part of the work to be done.
Sharon Kedar 24:13
Yeah, I think a key insight from what you're saying is this is about humanity. And this beautiful piece of your data is it's permission to dream. It's permission to have big, hairy, audacious goals and create business cases for a given disease, in a given country, based on the McKinsey/World Economic Forum data. And business cases are built on data. And so having access to this, it really gives me tremendous hope. I am a data-driven innovator, and I think that a lot of people who are going to fund this are going to need that data.
Sharon Kedar 25:01
If you could tell a friend or a woman three pieces of advice just for today, as we sit here in 2024, just based on what you know, knowing we're not gonna solve all this now, just curious what you would say.
Lucy Pérez 25:15
So first and foremost, make sure, you know, you're thinking proactively about this every time you have a healthcare interaction. When you're going to the doctor, asking the questions. Two, help raise awareness. Be having these conversations, be it with your girlfriends, with people at work, your family members. Have more conversations. Help raise that awareness. And to the extent that you can contribute to closing the gap, be it because of the job that you have, and, for example, if you are working in a pharma company, or you're, frankly, in any company, asking the question around what benefits do we provide for women's health? Or do you have the ability to contribute philanthropically, to direct dollars in your capacity as an investor? Think about the role that you can play in contributing to the resources that will be needed here to help close the gap.
Lucy Pérez 26:15
So help raise awareness. Think about yourself, because all of us will be patients at some point. So being educated to help yourself get to the best possible health outcome and think through what is that active role that you can play in closing the gap. Because again, everyone has a role to play, and when women are healthier, everyone benefits.
Sharon Kedar 26:35
Thank you, Lucy Pérez, you are incredible. It is absolutely wonderful, the work you're doing, and it gives hope and permission and data to a lot of people to hopefully make a paradigm shift over the coming years in women's health.
Lucy Pérez 26:50
And Sharon, thank you for all that you're doing to raise awareness to think about the funding that can happen and how we're helping support those investors that are looking to bring to the market new solutions that improve health outcomes for everyone. So thank you for having me here, for this enriching conversation.
Sharon Kedar 27:08
Thank you. Thank you for tuning in. Please connect with me, Sharon Kedar, on LinkedIn for additional innovative content. If you enjoyed this episode, please take a moment to like it. And don't forget to subscribe to the channel by clicking the button below this video. The views and opinions of the hosts and podcast guests are their own professional opinions and may not represent the views of Northpond Ventures.
About Your Host
Sharon Kedar, CFA, is Co-Founder of Northpond Ventures. Northpond is a multi-billion-dollar science-driven venture capital firm with a portfolio of 60+ companies, along with key academic partnerships at Harvard’s Wyss Institute, MIT’s School of Engineering, and Stanford School of Medicine. Prior to Northpond, Sharon spent 15 years at Sands Capital, where she became their first Chief Financial Officer. Assets under management grew from $1.5 billion to $50 billion over her tenure, achieving more than 30x growth. Sharon is the co-author of two personal finance books for women. Sharon has an MBA from Harvard Business School, a B.A. in Economics from Rice University, and is a CFA charterholder. She lives in the Washington, DC area with her husband, Greg, and their three kids.
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