The Hidden Healthcare Crisis: Women Pay More, Get Less Research

New data reveals stark disparities in gender-specific health funding while women shoulder disproportionate costs

The numbers tell a troubling story: while women comprise over half the U.S. population and spend significantly more on healthcare than men, research funding for women's health conditions remains dramatically underfunded compared to the burden these diseases impose.

The Financial Reality

Working women in America face a healthcare premium that extends far beyond the familiar "pink tax" on consumer products. According to new research from Deloitte, women spend $15.4 billion more annually on out-of-pocket healthcare expenses than their male counterparts, despite using only about 10% more medical care. This translates to 18% higher out-of-pocket spending per year for the average employed woman, even when pregnancy-related expenses are excluded.

The disparity becomes even more stark when examining prescription costs. In 2024, women spent $39.3 billion out of pocket on healthcare, compared to $30.5 billion spent by men—an $8.8 billion gap. Women between ages 18-44 bear the heaviest burden, sometimes spending up to 64% more than men in their age group.

Research Funding: Following the Money

While women pay more for healthcare, the research funding that could improve their outcomes tells a different story entirely. A groundbreaking analysis published in the Journal of Women's Health found that in nearly three-quarters of cases where a disease afflicts primarily one gender, the funding pattern favors males.

The National Institutes of Health (NIH), America's largest biomedical research funder with a $47.6 billion annual budget, allocated only 8.8% of research spending to women's health research between fiscal years 2013-2023. More concerning, this percentage has actually decreased from 9.7% in 2013 to 7.9% in 2023, even as NIH's total budget grew.

Cancer Funding: A Case Study in Disparity

Perhaps nowhere is the funding disparity more evident than in cancer research. While the number of men diagnosed with prostate cancer annually (218,890) exceeds women diagnosed with breast cancer (178,480), breast cancer research receives substantially more funding.

However, when examining cancers that predominantly affect women, the picture becomes more troubling. A study analyzing funding-to-lethality scores found that ovarian cancer ranked 10th out of 18 cancers (score 0.097), cervical cancer 12th (0.087), and uterine cancer 14th (0.057), while prostate cancer had the highest mean score at 1.81 and breast cancer followed at 1.80.

In dollar terms, prostate cancer received an average of $1.8 million per person-years of life lost per 100 incident cases, while ovarian cancer received just $97,000, cervical cancer $87,000, and uterine cancer $57,000.

The Economic Impact

The underinvestment in women's health research carries enormous economic consequences. A comprehensive McKinsey study found that closing the women's health gap could boost the global economy by $1 trillion annually by 2040. The study revealed that women spend an average of 25% more years in poor health than men—approximately nine additional years of illness across their lifetimes.

A Call for Change

Recent developments suggest growing recognition of this crisis. In August 2025, the Gates Foundation announced a $2.5 billion commitment through 2030 to accelerate research and development focused exclusively on women's health, targeting five critical, chronically underfunded areas.

Most significantly, a December 2024 report from the National Academies of Sciences, Engineering, and Medicine called for the NIH to form a new institute focused on women's health, backed by $15.7 billion in new funding over five years. The report recommended $4 billion for a dedicated institute and $11.4 billion for an NIH-wide fund to support interdisciplinary women's health research.

The Healthcare Experience Gap

The funding disparities translate into real-world healthcare experiences. Among people who visited a doctor in the past two years, women are more likely than men to say a healthcare provider dismissed their concerns (21% vs. 12%) or didn't believe they were telling the truth (10% vs. 7%).

This dismissal can have serious consequences. Research shows that women suffer more adverse drug reactions than men, largely because most drug dosing guidelines are based on male-dominated clinical trials. Adverse drug events account for up to 18% of hospital admissions in Australia and cost the U.S. healthcare system $30 billion annually.

Moving Forward

The evidence is clear: the current approach to healthcare research and funding creates a systematic disadvantage for women. As researchers at Nature concluded, "funding for research on women's health is still a fraction of that available for men's health".

The path forward requires coordinated action. Closing the women's health gap will require (1) investing in women-centric R&D, (2) strengthening collection and analysis of sex- and gender-disaggregated data, (3) enhancing access to gender-specific care, (4) encouraging investments in women's health innovation, and (5) examining business policies to support women.

As Dr. Anita Zaidi of the Gates Foundation noted, "For too long, women have suffered from health conditions that are misunderstood, misdiagnosed, or ignored. We want this investment to spark a new era of women-centered innovation—one where women's lives, bodies, and voices are prioritized in health R&D."

The question facing policymakers, healthcare leaders, and society is not whether we can afford to address this disparity, but whether we can afford not to.

---

SIDEBAR: What Would Fair Research Funding Look Like?

A Blueprint for Equitable Health Research Within Current Budgets

The United States spends approximately $4.5 trillion annually on healthcare—nearly 18% of the nation's GDP. Within this massive system, the NIH's $47.6 billion research budget represents just over 1% of total health spending. Here's how a fair allocation might work:

Current Reality vs. Fair Distribution

Today's NIH Budget Breakdown:

• Total NIH funding: $47.6 billion (FY 2024)
• Women's health research: ~$4.2 billion (8.8%)
• Men-dominant disease funding: Estimated $8-10 billion
• Gender-neutral research: ~$33-35 billion

A Disease Burden-Based Model: Using disability-adjusted life years (DALYs) as the fairness metric, research funding should align with actual health impact:

• Female-dominant diseases (affecting >60% women): Currently receive 15-20% less funding than their disease burden warrants
• Male-dominant diseases (affecting >60% men): Currently receive 20-25% more funding than burden suggests
• Balanced approach: Fund based on combined factors of disease burden, mortality, years of life lost, and population affected

The Path to Equity Within Current Spending

Option 1: Rebalance Existing Funds

• Reallocate $2-3 billion from overfunded areas to women's health research
• Increase women's health funding to 12-15% of NIH budget ($5.7-7.1 billion)
• Maintain overall NIH budget at current levels

Option 2: Targeted Increase (National Academies Recommendation)

• Add $3.1 billion annually to reach $15.7 billion over 5 years
• Women's health research would reach ~16% of expanded NIH budget
• Total cost: 0.07% of annual healthcare spending

Return on Investment

Research shows every $1 invested in women's health yields $3 in economic growth. Key areas for immediate impact:

High-Impact, Underfunded Areas:

• Endometriosis research: Currently $7 million annually vs. $2.5 billion economic burden
• Maternal mortality: $50 million research vs. $32 billion annual costs
• Menopause research: $20 million vs. $1.8 billion in lost productivity
• Autoimmune diseases: $291 million vs. $100 billion in annual treatment costs

International Comparison

Other developed nations allocate research funding more equitably:

• Canada: 12-14% of health research funding goes to women's health
• UK: 11-13% through dedicated women's health research streams
• Australia: 10-12% with specific gender equity requirements

Making It Work

Revenue-Neutral Approaches:

1. Redirect pharmaceutical company settlements: Use funds from opioid and other healthcare settlements
2. Optimize current spending: Eliminate duplicate studies and improve research efficiency
3. Private-public partnerships: Leverage the 314% increase in women's health VC funding
4. Insurance premium adjustments: Small increases (0.1-0.2%) could fund significant research expansion

Bottom Line: Achieving research equity would cost less than 0.1% of annual U.S. healthcare spending while potentially saving hundreds of billions in improved health outcomes and economic productivity.

---

Could This Impact Address America's Fertility Crisis?

The connection between women's health research funding and America's declining birth rates may be more significant than previously recognized. The U.S. fertility rate dropped to a historic low of 1.599 children per woman in 2024, well below the 2.1 replacement rate needed to maintain population stability.

The Research-Fertility Connection

Current reproductive health research receives minimal funding relative to its impact. In 2020, only 5% of global R&D funding went to women's health research, with just 1% allocated to all women-specific health conditions beyond cancer, and 25% of that limited to fertility research. This translates to less than 0.25% of global health research funding dedicated to fertility and reproductive health.

WHO reports that approximately one in six people of reproductive age worldwide experience infertility, yet solutions remain "underfunded and inaccessible to many due to high costs, social stigma and limited availability."

Current Barriers to Family Formation

The funding gap creates cascading effects that may contribute to delayed or foregone childbearing:

• High Treatment Costs: People in the poorest countries spend a greater proportion of their income on fertility care, with high costs preventing access to infertility treatments or catapulting families into poverty
• Limited Research Pipeline: Despite endometriosis affecting 190 million women and having "up to 10 years of delay in diagnosis," few treatment assets are in development pipelines
• Insurance Coverage Gaps: Most fertility treatments remain largely funded out-of-pocket, creating financial barriers

Potential Impact of Increased Investment

Enhanced women's health research funding could address fertility challenges through multiple pathways:

Improved Diagnosis and Treatment: Better understanding of conditions like endometriosis, PCOS, and unexplained infertility could reduce the average 7-10 year diagnostic delays that currently prevent timely intervention.

Cost Reduction: Research advances typically lead to more efficient treatments and broader insurance coverage, potentially making family planning more accessible to middle-class families.

Preventive Care: Better research into reproductive health across the lifespan could help women preserve fertility options and identify issues earlier.

While increased research funding alone wouldn't reverse demographic trends driven by economic factors, housing costs, and lifestyle choices, it could remove significant medical and financial barriers that currently prevent many Americans from achieving their desired family size.

As demographic researchers note, many Americans aren't deciding against having children entirely, but asking "Do I have the right partner? If I have another baby in child care, what would that do to my expenses? Does my job feel stable?" Reducing medical uncertainties and costs through better research could help more families answer these questions affirmatively.

---

Sources and Citations

1. McKinsey Global Institute (January 17, 2024). Closing the women's health gap: A $1 trillion opportunity to improve lives and economies. Available at: https://www.mckinsey.com/mhi/our-insights/closing-the-womens-health-gap-a-1-trillion-dollar-opportunity-to-improve-lives-and-economies
2. Gates Foundation (August 4, 2025). Gates Foundation Announces Catalytic Funding to Spark New Era of Women-Centered Research and Innovation. Available at: https://www.gatesfoundation.org/ideas/media-center/press-releases/2025/08/womens-health-funding-commitment
3. Mirin, A. A. (2021). Gender Disparity in the Funding of Diseases by the U.S. National Institutes of Health. Journal of Women's Health, 30(7), 956-963. PMC: https://pmc.ncbi.nlm.nih.gov/articles/PMC8290307/
4. Smith, K. (2023). Women's health research lacks funding – these charts show how. Nature. Available at: https://www.nature.com/immersive/d41586-023-01475-2/index.html
5. Spencer, R. J., Rice, L. W., Ye, C., Woo, K., & Uppal, S. (2019). Disparities in the allocation of research funding to gynecologic cancers by funding to lethality scores. Gynecologic Oncology, 152(1), 106-111. PMC: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6519051/
6. Deloitte Consulting (September 2023). Gender Differences in Health Care Expenditures. Cited in CNBC: https://www.cnbc.com/2023/09/26/working-women-health-care-costs-far-outpace-men.html
7. GoodRx (March 7, 2025). The Prescription Drug Gender Divide: Women Spent Over $8.5 Billion More Than Men in 2024. Available at: https://www.goodrx.com/healthcare-access/research/prescription-drug-gender-gap-women-spend-more
8. National Academies of Sciences, Engineering, and Medicine (December 2024). A New Vision for Women's Health Research: Transformative Change at the National Institutes of Health. Available at: https://www.science.org/content/article/nih-needs-new-institute-women-s-health-research-expert-panel-says
9. UC Davis Health (December 18, 2024). New report highlights ways to advance women's health research. Available at: https://health.ucdavis.edu/news/headlines/new-report-highlights-ways-to-advance-womens-health-research/2024/12
10. Kaiser Family Foundation (August 19, 2022). Women's Health Care Utilization and Costs: Findings from the 2020 KFF Women's Health Survey. Available at: https://www.kff.org/womens-health-policy/issue-brief/womens-health-care-utilization-and-costs-findings-from-the-2020-kff-womens-health-survey/
11. Centers for Medicare & Medicaid Services (2024). NHE Fact Sheet. Available at: https://www.cms.gov/data-research/statistics-trends-and-reports/national-health-expenditure-data/nhe-fact-sheet
12. Society for Women's Health Research (March 19, 2025). NASEM Releases Report Assessing Women's Health Research at NIH. Available at: https://swhr.org/nasem-releases-report-assessing-womens-health-research-at-nih/
13. Oliver Wyman (January 2023). Closing The Gender Health Gap. Available at: https://www.oliverwyman.com/our-expertise/perspectives/health/2023/jan/closing-the-gender-health-gap.html
14. Kamath, S. D., et al. (2024). Lack of resource 'equality' means research of the deadliest cancers is often underfunded. JCO Oncology Practice. Available at: https://www.healio.com/news/hematology-oncology/20240126/lack-of-resource-equality-means-research-of-the-deadliest-cancers-is-often-underfunded
15. National Institutes of Health (December 5, 2024). Statement on NASEM Report on Women's Health Research. Available at: https://www.nih.gov/about-nih/who-we-are/nih-director/statements/statement-nasem-report-womens-health-research