Published in PM Live
Monday 18th October marks World Menopause Day, a day founded to raise awareness about the menopause and provide support to those experiencing it. Despite menopause affecting half of the world’s population, and having at least 30 associated symptoms, it has largely been brushed off as just ‘that time of life’ by society and ignored by many in the pharma industry. As a consequence, women experiencing menopause often struggle with symptoms in silence.
In collaboration with Dynata, Research Partnership recently surveyed over 100 women in the UK approaching or experiencing the menopause. The survey showed that almost three quarters (73%) of women believe menopause is overlooked by society, and over one third find the idea of discussing the menopause difficult. Furthermore, despite the negative impact symptoms can have on day-to-day life, a quarter of women (24%) would find it difficult to discuss menopause with a healthcare professional, causing further impact on the uptake of treatment.
Much of the reluctance to treat menopausal symptoms can be attributed to the 2002 Women’s Health Initiative (WHI) study, which infamously associated hormone replacement therapy (HRT) with an increased risk of breast cancer among those included in the study. Although the risk of cancer was in actual fact much higher among older study participants (and later analysis of the data has shown fewer cancers in the age group 50-59 who are most likely to need HRT), the study seriously dented confidence in the therapy. At the time, thousands of women stopped taking their HRT and many have been reluctant to ever since, resigning themselves to a life of ‘putting up’ with symptoms (32% of women surveyed by Research Partnership said they would not consider taking HRT based on what they currently know about it). The study also affected HCP perceptions of HRT, with many HCPs reluctant to recommend HRT in the wake of this research, leaving women with nowhere to turn.
The landscape in recent years has started to change, so much so that two thirds (66%) of the women we surveyed agreed menopause is starting to be taken more seriously. Women of menopausal age are a powerful consumer group growing in confidence and in the West, celebrities such as Kim Cattrall, Emma Thompson, Davina McCall and Michelle Obama are helping to open up the conversation, encouraging women to demand better access to care and treatment, rather than suffer in silence. Nevertheless, almost three quarters (71%) of the women we surveyed want menopause to be taken much more seriously, particularly because, according to more than half, there is still a stigma around the subject of menopause. 61% of women we surveyed believe this is thanks to the media perpetuating negative stereotypes.
In addition, some areas of the pharma industry are now starting to take note. According to Werner Lanthaler, CEO of Evotec AG (a long-time partner of Bayer AG, well-known for their role in advocating for women’s health) in an interview with In Vivo, a decade ago only a few key companies were considered ‘experts in the space’, whereas today more and more companies are addressing women’s health needs beyond fertility and contraception. According to data from Informa’s Pharma Intelligence’s Pharmaprojects, there are a greater number of companies pursuing clinical studies for menopause treatments than for any others that fall under the spectrum of women’s health.
Historically, there’s been very little focus on non-hormonal alternatives to HRT. Dr Mary Kerr, the co-founder of KaNDy Theraputics (a UK biotech with a novel non-hormonal oral compound in development for the alleviation of vasomotor symptoms of the menopause), believes this is primarily because the condition is not seen as a ‘serious condition’ but rather just ‘symptoms’, with little acknowledgement of how debilitating menopause symptoms can be. Two thirds (67%) of the women we surveyed agreed with Dr Kerr, believing menopause should be viewed as a medical condition and therefore treated as such. Furthermore, 69% agreed there should be more treatments available for the symptoms of menopause. However, the acquisition of KaNDy by Bayer, and the recent unveiling by Astellas of positive topline results from two phase 3 clinical trials for their non-hormonal drug for moderate – severe vasomotor symptoms – has led to alternatives to hormone therapy being investigated.
‘Beyond the pill’ solutions are also gaining traction – the global femtech solutions industry market is estimated to hit $1.15 billion by 2025 from $648 million in 2020, registering a compound annual growth rate (CAGR) of 12.2%, driven in particular by the menopause segment. Additionally, several companies are playing an active role in the ‘conversation’ – Pfizer has released a podcast focused on challenging the taboos of menopause, while Organon, the female health spin-off of Merck, promises to ‘give women the microphone’.
It isn’t just in the West where there is more focus on menopause. Tena have been working on changing the language around menopause in Saudi Arabia (where the word menopause translates to ‘the age of despair’). A survey by the brand found that 81% of Saudi women believe the language should be changed to be more positive. In India, Bollywood Netflix drama Bombay Bodrum features a scene including a powerful female CEO experiencing a hot flush, and film ‘Painful Pride’ focuses on a woman’s struggle with the symptoms of menopause, and how she and her family come to accept it. This is particularly ground-breaking in a country where menopause is still very much shrouded in secrecy and shame. However, Dr Anita Shah, secretary of the Indian Menopause Society, maintains that while these movements are positive there is a lot still to be done – there is very little awareness of menopause, with older women in particular still believing the topic to be taboo.
So, what does this mean for pharma and the healthcare market research industry? As the landscape continues to change, it is more important than ever for our clients to listen to the voices of their female customers in order to understand how their needs are best served. Almost two thirds (63%) of the women we asked believe there still needs to be more open discussion about the menopause. Therefore, it is no longer satisfactory to make assumptions about menopause management and treatment without putting women front and center of the discussion. Market research can help pharma clients understand the needs of the female customer base by speaking to them directly and fully exploring not only their treatment needs and wants, but also any barriers that need to be overcome, in order to help clients to tailor treatment in a meaningful way. Research also needs to ensure that these discussions are navigated in a culturally appropriate way. It is important to understand that addressing a sensitive topic should not take a ‘one size fits all’ approach, especially outside of the West. Subject matter should be explored with sensitivity, taking cultural norms into account in order to ensure research outputs are globally meaningful.
As well as understanding the menopause customer, it is important to understand and support HCPs so that they can offer the right help for their patients. Reticence around HRT prescription should be addressed, and it is important that HCPs understand the impact of menopausal symptoms and are empowered to offer the right help. To facilitate behavior change, research with physicians can be designed with behavioral science principles in mind, allowing for an exploration of unconscious beliefs and biases that HCPs may have that prevent them from offering optimum care, and can help our clients to shift these beliefs to offer women better experiences.
As the conversation continues to evolve, my hope is that pharma can play a key role in empowering women to have a positive experience at this stage of their lives. If you’re working in this space and would like to get a deeper understanding of patients’ attitudes, behaviors and unmet needs, contact us today. We are experts in Female Health and have conducted over 80 projects covering a wide range of global markets. In addition, we have specialized Emerging Markets and Behavioural Science teams, who we work in collaboration with to help pharmaceutical clients fully understand the market landscape.