From Compelling to Covered, Fixing Women’s Health’s Hidden Coverage Bias

At least $4.3B in lost annual U.S. pharma revenue. $51B over eight years. A landmark study by ZS’ Women’s Health Expertise Hub finds this is what payer directors’ coverage decisions cost the women’s health industry. Owing in part to the reality that, despite drug profiles with female indications receiving highly compelling ratings nearly twice as often they are twice as likely to be denied coverage as those with ‘male’ indications.

Drawing on findings from 60 U.S. pharmacy and medical directors, this session charts the path to a solution. Without relitigating bias, this presentation will focus on how payer and pharmaceutical leaders can turn compelling into covered, with:

• A concrete framework for building payer-ready evidence before launch, not after
• Reframing techniques to turn strong clinical value into fundable assets
• A shared playbook both sides can use to close the compelling-to-coverage gap in future launches