A recent Milken Institute report examines how insurance coverage and reimbursement challenges are limiting access to women’s health innovations and making commercialization more difficult.
Developed by the Women’s Health Network’s Coverage and Reimbursement Working Group, the report identifies nine key barriers, including the undervaluation of women’s health, fragmented payer pathways, limited billing and reimbursement mechanisms, gaps in sex-specific evidence, reimbursement uncertainty, administrative complexity, prior authorization, and limited clinician adoption.
To improve commercialization and patient access, the report outlines three go-to-market strategies: self-pay models, commercial payer coverage, and public programs like Medicare and Medicaid. It also calls for earlier payer and clinician engagement to better align evidence generation with coverage requirements and integrate new solutions into clinical workflows.
As more women’s health companies bring new care models and products to market, coverage and reimbursement remain a critical hurdle to translating innovation into broader patient access.
