What to Think about New Women’s Health Technology: Finding the Right Balance
Sometimes it’s easy for NWHN to develop its analysis of new women’s health technology. Our approach to this task is powerful; we look at the science underpinning something new and ask: does it work? What are the risks? What’s missing in the scientific information: what don’t we know? Were certain groups of women left out of the research process? The approval process?
We listen to what women tell us about the condition or treatment and learn what women themselves think would make a difference. We take into account any biases that might influence recommendations for or against something new: does one type of specialist benefit from promoting, or disparaging, something new? Are marketing claims exaggerating the need for the new technology or benefit?
When we engage in this process, we generate our analysis. Sometimes, our analysis is short and sweet: menopause hormone therapy works for hot flashes, but hasn’t been proven to prevent wrinkles. Blood tests to diagnose menopause are waste of time and money. Baseline mammograms at age 35 aren’t an effective screening tool.
But, sometimes our analysis isn’t short or simple. Two articles in this issue deal with topics on which NWHN has developed a fairly complex analysis. Our cover story on fibroids explains common technologies that help women deal with fibroids. NWHN’s position on the various treatment options considers several complicating factors. First, too many U.S. women are encouraged to have unnecessary hysterectomies for fibroids that don’t need treating. We believe this rush to surgery may be influenced by money, as those who are told they need a hysterectomy are often well-insured or rely on Medicaid for health benefits. At the same time, some women really do suffer from pain and heavy bleeding from fibroids, and they want treatment that is effective and easy to tolerate. Finally, these uncertainties are experienced more often by African American women, who are much more likely to develop fibroids than are other women, and no one knows why. Our story explores what we know about common treatments, while keeping in mind NWHN’s analysis that this condition is too often over-treated.
“The FDA Approves the HPV Vaccine” by Kristen Suthers, tackles a similarly complex subject: vaccination against Human Papilloma Virus (HPV). HPV vaccines are intended to reduce women’s risk of infection with HPV strains linked to genital diseases including cervical cancer. The science isn’t very complicated—the studies look good and the FDA review found no safety concerns—but the social and political issues are complex.
Cervical cancer is almost non-existent in the U.S. because of widespread Pap tests and easy access to clean water (toxic chemicals on clothing and/or skin are co-factors in this cancer’s development). Universal health care that meets the needs of women who are not screened in the current system would likely do more to eliminate cervical cancer deaths than will vaccinating millions of young girls. But, we have an effective vaccine and we don’t have universal health care. Thus, we argue that pharmaceutical companies should ensure that the vaccine gets in the right hands: underserved women without access to health care who are at high risk for cervical cancer. Concurrently, the companies’ marketing campaigns should ensure that women know they need regular Pap tests, even if they’ve been vaccinated. NWHN supports the HPV vaccine, but our analysis drives us to critique several aspects of its promotion, including marketing campaigns that create a climate of fear among women, and the vaccine’s outrageously high price–which will likely keep it out of the hands of the underserved women who need it most. If you have questions about these topics, or our analysis, we invite you to contact NWHN for more information.