In the women’s health space, Dr. Daisy Robinton’s voice is powerful. After selling her company Oviva Therapeutics, Robinton understands first-hand the challenges facing innovative women’s health companies. A lack of investors at the growth stage is a well-known hurdle, but so too are reimbursement challenges for therapeutics tailored to help women. If insurance companies won’t pay for options, patients must: an economic burden.
“Our field is not driven by unmet need,” she says. “It’s driven by the market and the structures. That’s what we need to change.”
Don’t miss Dr. Robinton’s talk at DOC 2025 during “The Great Healthcare Correction: Women’s Health” session in the video below, or read her lightly edited transcript.
TRANSCRIPT:
Daisy Robinton
Hello, everybody. I’m Daisy, it’s such a pleasure to meet you all. Thank you for staying for the very last session. I know there’s been a lot of information and content, and you’re all baking and simmering in it, and I’m actually quite excited that we get to be last so we can have that last word and be the last thing that you’re really thinking about as you leave and, are inspired and percolating and all of these incredible ideas and conversations and of course, thank you, Jordan and Kevin and John, for having us.
To the working group that enabled our panel to be here talking about what we’re talking about. I’d love to tell you a little bit about Oviva and what I built and why. But I’m more excited to talk about the opportunities, aka structural barriers that companies like ours face and have faced and continue to face and what the roadmap is to seeing more success and innovation reach the hands of patients and people in this space.
I’m a molecular biologist by training. I did a PhD and a postdoc, really looking at the intersection of early developmental biology and aging and pathology. When I was 31 years old, I went to a reproductive endocrinologist just to kind of figure out what my fertility journey might look like, and was horrified to learn that despite having a PhD in human biology and translational medicine, I was shockingly ignorant about my own body and physiology, and that sent me down a rabbit hole to better understand ovarian physiology and the science of female physiology and, I think Brit will probably be pleased to learn that the thing that horrified me most was that when I went through menopause, my sex life would tank. I was like, this cannot stand. I must do something literally. That was one of the main drivers. I can’t handle that for 40% of my life. I went on this deep dive just to better understand what is it about the ovaries that support overall health and well-being?
What can we do so that a second half of our lives can be as rich and vibrant and sexy as the first? Well, maybe not the first half, sexually active part. That got weird. I ended up starting a company called Oviva Therapeutics in partnership with my co-founders, David Pepin and Pat Donahue from MIT and Harvard, who are two incredible, fabulous minds that built the foundation of the biology around the protein called AMH, which we heard a little bit about yesterday, currently in use as a clinical biomarker marker to approximate ovarian reserve.
Now, the cool thing about AMH is it’s actually a regulator of how quickly our eggs are lost throughout the course of our lifespan. If you’re a cycling woman before menopause, you’re losing about 1000 eggs per cycle. That’s to ovulate one. So there’s this enormous waste. We don’t really understand why we want or need a thousand eggs to be lost with every cycle.
And AMH actually controls if we have a high number or a low number of eggs that are being released every month to mature and potentially be the one that ovulate. Our thesis advisor was, could we use this as a therapeutic strategy to reduce that number of eggs that were lost every month, as a means to extend the runway of time, that our ovaries are able to function before they then fail and go into menopause.
As Brit mentioned, we sold our company earlier this year to Granata Bio. They’ve sort of carried the mantle. But I’ll just say briefly, as a company that really built a framework around, single asset therapeutic strategy with a much broader potential and long term goal for how we’re going to improve health span and women, we really struggled in the awful market that has proceeded the last couple of years, to find investors that were willing to take that risk and carry forward the incredible science we had to see the fruition that is possible.
In many ways, that’s actually what led us to sell the company, it’s because the risk, is able to be born by a different structure. Somebody that has a diversified portfolio. It just wasn’t going to work as a single asset play, and there’s a lot of companies in the women’s health space that suffer from this because they have this really deep focus. They’re trying to solve the problem, and you have to do that with really high specificity, because complexity is already so enormous that when you start broadening too much, you really lose your ability to be effective.We start getting into some of the reasons that we see failures in this place. There’s five that I really want to talk about.
The first is funding, which I won’t belabor because everybody talks about it and it’s a little bit boring, but I’ll just say briefly that we are seeing improvements in funding for women’s health, but we’re still seeing a failure at the growth stage. A lot more capital is going in for these early stages, seed and pre-seed, even series A, and we’re not seeing that convert of series B in large part because of the broader structural needs that are enabling scaling.
The second is diagnosis. This goes to Roma’s points around data. We don’t have the data. Paired with that we don’t actually have the language. So we don’t really understand how to talk about many of the conditions in women’s health, much less at the biological level, what’s really happening and how to diagnose and treat those. Without diagnoses we can’t have ICD codes.
This is another enormous barrier for anybody, especially in the therapeutic space. If there’s not an ICD code, there’s not a mechanism for reimbursement. So who’s paying for that? That’s why we often go direct to consumer and why there’s a lot more direct to consumer plays coming up. But again this gets to the scale program. If we’re going to solve for the female population in the country and on the earth, we really need to solve this problem.
Next is the adoption and reimbursement. We talked a lot yesterday about adoption and clinical training for OB/GYNs and other physicians and how to get them up to speed on managing and understanding female physiology. But we also have a huge reticence to adoption for technologies and therapeutics in women’s health. In large part because the clinical practices that focus on women’s health tend to be the most financially stressed and the least incentivized to adopt something new certainly, if there’s not strong reimbursement. So these are some of the pillars of structural barriers that I think are really flagged and important for companies in our space and for people that are interested in supporting companies in these space to really have an eye on and a plan for in order for there to be a path to success.
What I’m really excited about with all of these is that you cannot be successful as a company in women’s health without having an eye on these, and at the same time, these problems aren’t necessarily unique to women’s health. They’re problems that exist, at least in the United States broadly. As we all know, our health care system deliver some of the poorest value among our peer groups.
Globally, we’re spending $5 trillion a year for national health expenditures, and that’s to get four years lower life expectancy than our peer countries, and 20% of our GDP for having increased maternal mortality rates, infant mortality, hypertensive chronic disease, to name just a few. We all know that there’s reform that’s needed. I think what’s exciting to me is that women’s health companies are really poised to be the leaders of this charge, because we already have to be thinking about that.
If you don’t have a plan in that, you’re not going to be successful. I think, generally speaking, we need reform. We need radical transformation to be brought forward by some of these companies that are thinking about how to innovate broadly as well as innovate technologically in the lanes that we’re in just a few ideas to see this.
I ran out of time. I’m sorry. I’ll take 30 more seconds. Just a few ideas to see this discussion and get everybody here thinking, one of the things that we need to be doing is generating the regulatory and adoption pathways. So thinking from the regulatory stance standpoint, but also for the clinicians, clinician training, reform the reimbursement. Generating pilot ICD codes so that we can actually incentivize the adoption of and pay for these new innovations, expanding the FDA flexibility for technology in the women’s health space. I know that’s something that there’s at least been conversation around and interest in for the last couple years, at least in some of the interactions I’ve had with the FDA and and in rooms that I’ve been in with folks from the FDA, and just an acknowledgment that this dilution is very complex and multifaceted. It requires everybody in this room and all of the health equity stakeholders to have a hand in. That’s going to be the innovators, that’s going to be the government, that’s going to be the patients and the providers. I do think an enormous part of the ask is really bringing this awareness forward. Because certainly when I started in this field many years ago, none of this was visible to me. I just thought, oh, there’s unmet need and really amazing, strong science. Of course this can work. How naive. Right? That’s just not true. This is not driven by unmet need. Our field is not driven by unmet need. It’s driven by the market and the structures. That’s what we need to change. I think it’s an invitation for our companies to lead that charge. Thank you.