Blueprint to Close the Women%E2%80%99s Health Gap 2025

The WHO publishes a Model List of Essential Medicines; if a medicine is on this list, the WHO considers treating the condition and accessing the associated therapeutics as essential for a country’s health system. CPGs are standardized recommendations that clinicians follow to diagnose and treat conditions. This analysis demonstrated the presence – and absence – of global pharmaceutical data across CPGs and essential medicines lists (EMLs) for the selected conditions and, subsequently, the lack of prioritization of treatments for women’s health conditions. In carrying out this analysis, the Forum and MHI used comprehensive sources of global pharmaceutical volume data, knowing that no single-source database exists to provide details for all generic medicines, over-the-counter medicines and branded therapeutics. After consulting with experts in working groups, the IQVIA database was used for this analysis to provide the most complete picture. While this database is one of the most comprehensive sources of global pharmaceutical data, quality of medications, limited coverage of generics and lack of tracking of non-pharmaceutical interventions are caveats: 1. Medication volume data is not indicative of the quality of medications, availability of medications or whether patients are able to access medications across countries. 2. Limited data coverage for generic medications likely compounds the data gap from regions in which most medications used are generic, particularly for LICs and LMICs. 3. Non-pharmaceutical interventions indicated in treatment guidelines are not tracked. Non- pharmaceutical interventions include surgical procedures, which are particularly important to note for conditions such as endometriosis (for which laparoscopy is used for diagnosis and treatment) or breast cancer (for which mastectomies may be performed) or cervical cancer (for which loop electrosurgical excision procedure [LEEP]) therapy is a common treatment. Diagnostic tools are also not covered. Overall, the Forum and MHI analysis found that medications recommended in CPGs are not comprehensively tracked in global pharmaceutical databases for 33% of the selected conditions – migraine, PMS and ischaemic heart disease.The Model List of Essential Medicines includes medications for only six of the selected conditions (ischaemic heart disease, breast cancer, cervical cancer, migraine, maternal hypertensive disorders and post-partum haemorrhage). This implies that only 67% of the selected conditions are determined to have medicines that offer the greatest benefits to a population and should be available and affordable. Even for the selected conditions present in the Model List of Essential Medicines, the Forum and MHI analysis found that only one-third of the medicines included in the Model List are comprehensively tracked in global pharmaceutical data. Women-specific conditions that affect the health span – PMS, menopause and endometriosis – lack EMLs.75 This may reflect the lack of understanding of the burden of these conditions on women, families, communities and economies. As a result, the sense of how (and how well) women are managing pain is limited. In other words, for some of the most prevalent conditions in the world, the WHO does not recommend that countries include the treatments for these conditions as essential medicines, and tracking for the treatments that are being used (e.g. over-the-counter pain relievers) is limited. The Forum and MHI analysis found that 83% of medications referenced in menopause CPGs are tracked in the global pharmaceutical data, including oestrogen, progesterone and other hormonal treatments.76 While specific medications are tracked in global pharmaceutical data, limited data on compounded hormone therapies and tailored dosing of hormone therapies is collected. This potentially underestimates the treatments used and limits the understanding of the effectiveness and side effects for women using compounded and tailored therapies. Additionally, the quality or availability of medications for women is not reflected in this analysis. Understanding whether providers and patients can obtain recommended medicines in different geographical areas – even for medications deemed “essential” – is challenging. Furthermore, the data does not reflect whether therapeutics are reimbursed by payers, either through national mandates or through individual payer formularies and coverage guidelines, highlighting additional questions regarding access. Blueprint to Close the Women’s Health Gap: How to Improve Lives and Economies for All 16