Advancements in Women’s Health and Sustainable Development Goals (SDGs)

Introduction

Awareness of women’s health is increasing nationwide, marked by significant developments such as the FDA approval of Miudella—the first new non-hormonal intrauterine device (IUD) in over 40 years—and Aetna’s expansion of fertility coverage to include intrauterine insemination benefits for all members regardless of sexual orientation or partner status. These advancements align closely with the Sustainable Development Goals (SDGs), particularly SDG 3 (Good Health and Well-being) and SDG 5 (Gender Equality), by promoting equitable access to healthcare services for women.

Formulary Treatment of Women’s Health Therapies

1. Coverage Variability: Coverage for menopause-related therapies varies by insurer and plan type (commercial, Medicaid, Medicare), with a common focus on FDA-approved therapies.
2. Exclusion of Non-FDA Approved Therapies: Many widely used therapies, such as bioidentical hormone therapy, are generally not covered due to lack of FDA approval.
3. Prior Authorization: Some FDA-approved therapies require prior authorization to balance clinical decision-making, cost, and efficacy.

This approach supports SDG 3 by ensuring safe and effective treatment options are prioritized within healthcare systems.

Miudella: A New Non-Hormonal IUD Option

• Description: Miudella is a new, non-hormonal copper-based IUD lasting eight years, offering an alternative for women unable or advised against using hormone-based contraceptives.
• Benefits: Its flexible design reduces pain during insertion, enhancing user comfort and accessibility.

Miudella contributes to SDG 3 by expanding contraceptive choices and supporting reproductive health.

Expanded Fertility Coverage by Aetna

• Market Leadership: Aetna is the first major insurer to cover intrauterine insemination for all members regardless of sexual orientation or partner status.
• Infertility Prevalence: Approximately 2.4 million women in the U.S. experience infertility, underscoring the need for broader coverage.
• Coverage Challenges: Cost constraints and employer decisions affect the availability of infertility treatment coverage.
• Equity Focus: Aetna’s policy promotes equitable healthcare access, aligning with SDG 5 by addressing disparities in reproductive health services.

Role of Managed Care Pharmacists in Expanding Access

1. Education and Navigation: Pharmacists help patients understand treatment options and coverage complexities.
2. Ensuring Appropriate Therapy: They balance clinical efficacy with affordability to optimize patient outcomes.

These efforts support SDG 3 by improving healthcare delivery and patient adherence to therapies.

Addressing Disparities in Coverage and Access

• Existence of Disparities: Variations in coverage by plans and pharmacy benefit managers (PBMs) contribute to unequal access.
• Strategic Priorities: The Academy of Managed Care Pharmacy (AMCP) has prioritized closing healthcare gaps related to socioeconomic status and population needs.
• Clinical Guidelines: Use of evidence-based clinical data helps reduce disparities, exemplified by migraine treatment more common in women.
• Affordability: High cost-sharing correlates with non-adherence, highlighting the need for affordable healthcare solutions.

These initiatives align with SDG 10 (Reduced Inequalities) and SDG 3 by promoting equitable healthcare access and quality.

AMCP Initiatives to Improve Equitable Access

1. Health Equity Action Briefs: Developed resources to assess and address health equity, including utilization of CMS Z codes for social determinants of health.
2. Member Engagement: Encouraging members to embrace health equity as a core issue.
3. Partnerships: Collaboration with organizations like SCAN Health Plan to serve minority and rural populations.

These efforts contribute to SDG 3, SDG 5, and SDG 10 by targeting systemic inequities in medication access and use.

Impact of Formulary Policy Changes on Patient Outcomes

• Cost Sharing: Reducing patient cost-sharing improves medication adherence and outcomes, though other factors also influence adherence.
• Multifactorial Considerations: Understanding individual and population-level factors is essential for optimizing therapy effectiveness.

This focus on affordability and adherence supports SDG 3 by enhancing health and well-being through improved treatment outcomes.

Conclusion

The advancements in women’s health therapies, insurance coverage policies, and managed care pharmacy practices demonstrate significant progress towards achieving the Sustainable Development Goals, particularly SDG 3 (Good Health and Well-being), SDG 5 (Gender Equality), and SDG 10 (Reduced Inequalities). Continued efforts to expand access, reduce disparities, and improve affordability are critical to ensuring equitable healthcare for all women.

1. Sustainable Development Goals (SDGs) Addressed or Connected to the Issues Highlighted in the Article

1. SDG 3: Good Health and Well-being
   • The article focuses on women’s health, including access to contraception, menopause management, infertility treatments, and reducing healthcare disparities.
   • It emphasizes improving health outcomes, equitable access to healthcare services, and coverage for essential therapies.
2. SDG 5: Gender Equality
   • The article addresses women’s health issues, equitable coverage regardless of sexual orientation or partner status, and reducing disparities affecting women and minorities.
   • It highlights the importance of gender-sensitive healthcare policies and access to reproductive health services.
3. SDG 10: Reduced Inequalities
   • The article discusses healthcare disparities among different populations, including minorities and rural residents.
   • It focuses on closing gaps in medication access and use, and promoting equitable healthcare coverage.

2. Specific Targets Under Those SDGs Identified Based on the Article’s Content

1. SDG 3: Good Health and Well-being
   • Target 3.7: Ensure universal access to sexual and reproductive healthcare services, including family planning, information, and education.
   • Target 3.8: Achieve universal health coverage, including financial risk protection and access to quality essential healthcare services and medicines.
   • Target 3.b: Support research and development of vaccines and medicines for communicable and non-communicable diseases.
2. SDG 5: Gender Equality
   • Target 5.6: Ensure universal access to sexual and reproductive health and reproductive rights as agreed in accordance with the Programme of Action of the International Conference on Population and Development.
3. SDG 10: Reduced Inequalities
   • Target 10.2: Empower and promote the social, economic and political inclusion of all, irrespective of age, sex, disability, race, ethnicity, origin, religion or economic or other status.
   • Target 10.3: Ensure equal opportunity and reduce inequalities of outcome, including by eliminating discriminatory laws, policies and practices.

3. Indicators Mentioned or Implied in the Article to Measure Progress Towards the Identified Targets

1. Indicator 3.7.1: Proportion of women of reproductive age (15-49 years) who have their need for family planning satisfied with modern methods.
   • Implied through discussion of new contraceptive options like Miudella and expanded fertility coverage.
2. Indicator 3.8.1: Coverage of essential health services.
   • Implied by the focus on insurance coverage for women’s health therapies and infertility treatments.
3. Indicator 3.8.2: Proportion of population with large household expenditures on health as a share of total household expenditure or income.
   • Discussed in relation to cost sharing and affordability affecting adherence to therapies.
4. Indicator 5.6.1: Proportion of women aged 15-49 years who make their own informed decisions regarding sexual relations, contraceptive use and reproductive health care.
   • Implied by the availability of new contraceptive options and equitable coverage regardless of sexual orientation or partner status.
5. Indicator 10.2.1: Proportion of people living below 50% of median income, by age, sex and persons with disabilities.
   • Implied in addressing disparities in healthcare access among minorities and rural populations.
6. Use of CMS Z codes: Mentioned as a data tool to assess health equity and disparities in medication access and use.

4. Table of SDGs, Targets, and Indicators

Source: managedhealthcareexecutive.com