A Perspective on Reducing the Women's Health Gap

An Interview with Dr. Tabetha Sundin, Head of Diagnostics, Global Medical OBU, AstraZeneca on International Women’s Day
by Madhushree Ghosh, PhD, Senior Vice-President, Global Strategic Partnerships, Biocartis Global

An alarming statistic in the recent McKinsey Health Institute report should make all of us in the medical, diagnostic and pharmaceutical business pay attention. According to the data, while we have more than doubled our life expectancy in the past two centuries, women spend nearly a decade of their lives in poor health and in varying degrees of disability (the health span versus life span). The numbers suggest that women spend as much as 25% more time than men in ‘poor health’.  Which in turn, reduces women’s productivity, at home and in the workforce, in turn reducing their earning potential.

In terms of economics, women’s health gap equates to 75 million years of life lost due to poor health or early death per year, the equivalent of a week per woman, per year. The economic gap change ultimately equates to a trillion dollars in potential, be it in healthcare, better working and life conditions, and/or health decision-participation.

Biocartis, with its unique Idylla Platform, has been working in women’s health and diagnostics for many years. To date we continue to build our Women’s Health portfolio, and partner with pharma and clinical labs to ensure our oncology tests expedite accurate gynecological cancer detection. Valued by pharmaceutical groups, hospitals, community clinics and academia globally, our assays focus on MSI, other gynecological markers and ESR1 as a partner distributed kit.

To honor International Women’s Day, we decided to listen to the perspective of Dr. Tabetha Sundin on reducing the women’s health gap. Dr. Tabetha Sundin was previously Scientific Director of the molecular and serology diagnostics labs of Sentara Healthcare and her current role at AstraZeneca focuses on women’s health, oncology diagnostics and enabling patients to access testing and subsequent treatment efficiently. AstraZeneca is a global leader in gynecological oncology drugs with a focus on women’s health and has a robust oncology pipeline in women’s oncology (ovarian & other gynecological cancers, breast cancer and lung cancer).

By challenging the status quo and bringing awareness, we hope to work toward reducing the ‘poor health’ timeline, improving overall health and economic quality of life.

Madhushree Ghosh: McKinsey Health Institute recently noted the need for us to look at a trillion dollars’ opportunity in improving lives and economics by focusing on women’s health. On International Women’s Day, how do you as an individual, woman leader in diagnostics and pharma view your role in reducing the women’s health gap?

Tabetha Sundin: As a pharmaceutical company whose ambition is to cure cancer as a cause of death, I think we have a responsibility to ensure we are investing in closing the women’s health gap. Equitable access to care is something we strongly believe in. By focusing on women's health, AstraZeneca can address unmet needs and contribute to improving health outcomes for half the population. Additionally, we have a strategic focus in cancer types that affect females more frequently than males such as breast cancer, EGFR mutated lung cancer, and of course gynecological cancers. We cannot strive towards a cure for these cancers if we ignore the broader women’s health gap.

MG: As part of the diagnostics leadership team within AstraZeneca, Global Medical OBU, what motivates you (and your team) to focus on Women’s Health?

TB: I am passionate about addressing inequities. I am fortunate to be in a position that can impact the global population. And honestly, it’s the right thing to do. Ensuring we decrease barriers to care is a major focus of the medical team at AstraZeneca. We also work in tumor types that are highly prevalent in women such as breast cancer, lung cancer and gynecological cancer. Our mission to improve patient outcomes for these tumors cannot be accomplished if we do not focus on equity and improving women’s health.

MG: In oncology patient care, what are you and your colleagues doing to address the gaps from diagnostics to treatment?

TB: We are working to decrease barriers to guideline concordant care as a core part of the medical mission at AstraZeneca. The gap in access to guideline concordant care is not specific to any one gender, however work in this area will help uplift women’s health as they represent half of the population. There are many therapies available that require biomarker testing to select the right patient for the right treatment. In order for the therapy to be properly given to a patient, the biomarker status needs to be known at the time of the therapy decision.

MG: The latest CDRH guidance/intention to downgrade most high-risk IVDs may lead to a faster access to patient care (and diagnostics), ultimately helping healthcare. What are your thoughts on this process and why should pharma care?

TB: The main focus of my day job as a leader for global medical diagnostics is to reduce barriers to guideline concordant care. Biomarker identification is required for many of the therapies in our portfolio and pipeline. And of course we want the highest quality testing for our patients. Part of providing guideline concordant care means that the biomarker test result must be back in time for the physician to make a treatment decision. I am supportive of changes that increase the probability of this occurring by improving access to biomarker testing.

MG: Minority representation in clinical trials is a major gap in drug development processes. Where are we failing and why?

TB: Historically, medical research has been male dominated, which can lead to gaps in knowledge about women's health. We don’t change what we don’t measure. I believe there has been a lack of awareness of the problem and willingness to measure and set goals for impactful change. There may also be specific barriers for females enrolling in clinical trials, such as lack of a support system to balance duties at home. This may decrease a female’s likelihood of agreeing to participate in a clinical trial which requires more office visits and therefore less time at home. We are sponsoring research into this area, so we better understand the drivers and barriers to women enrolling in clinical trials.

MG: How is AstraZeneca (and your team) working toward a fair and diverse clinical trials strategy? And is it working? Why/why not?

TB: We believe clinical trials populations must reflect the patients they serve, and understand how drugs perform in diverse patient populations. AstraZeneca has a clinical trial diversity strategy with the ambition to ensure clinical trial participants mirror the characteristics of disease populations. We have taken a data driven approach to recognizing and proactively addressing issues with diversity in clinical trial enrollment.

The AstraZeneca medical team has also collaborated with multiple societies to provide explicit bias training to ensure that all patients are offered access to clinical trials. We are also sponsoring research to understand the root cause of why some populations such as females are not enrolling in clinical trials at the same rate as other populations.

MG: If we had all resources to close the gap in gender equality as it is in healthcare and diagnostics, what do you think is top priority for us in oncology/women’s health? And why?

TB: I believe the first step here is to create awareness of the issue. If we can measure the impact of not focusing on women’s health and tell the story, I believe we can get a lot of momentum behind this. I am personally focusing on how we, as pharma, are able to support gender equality. We are engaging with external experts to better understand our role in the development and support of female experts working in oncology. There are quick wins such as ensuring we have gender parity when we engage external experts and then there are much larger ambitions such as formal mentorship programs and research to measure and quantify issues within the oncology space for women.