She’s spent a decade improving women’s healthcare—now her startup is on the brink of failure

Evofem Biosciences CEO Saundra Pelletier is one of the most dynamic, and complex, entrepreneurs I’ve profiled For the past two months, as Evofem teetered on the brink of failure, he has been the most willing to discuss his company’s growing fortunes in real-time.

Beginning in 2013, Pelletier spent ten years grappling his small pharma company with a soap opera’s worth of business woes: costly regulatory limbo; product hazard; Even personal tragedies, including plane crashes and cancer diagnoses. “I have never met a woman with so much energy in my life. Ever,” said Russell Barnes, former chief commercial officer of Evofem.

But today, Pelletier’s ability to overcome seemingly any obstacle is being severely tested. Evofem’s shares have been delisted from Nasdaq, and its sales aren’t growing fast enough to cover its losses (or debt load). Last month, the San Diego company parted ways with Pelletier’s remaining employees, including members of its C-suite: its CFO resigned, its chief commercial officer was laid off, and its 35 remaining employees took a 20% pay cut. (Pelletier’s own salary was cut 40% to $520,000.)

“We’re on life support,” she says. “There’s nothing I wouldn’t do to make this company a success.”

There are many reasons for Evofem’s current predicament, including some of Pelletier’s own making, as I report in a new profile and investigation. fate. But the biggest financial challenge facing Evofem—and all the entrepreneurs and executives trying to innovate in its key markets—has to do with our broken healthcare system.

It’s part of a much bigger story about how reluctant big drugmakers and investors are to spend money on the serious business of women’s health. Women account for 51% of the population and 80% of US health care purchasing decisions. Yet Big Pharma spends only 1%According to McKinsey, all R&D investments on female-specific conditions other than cancer — not a typo. Things aren’t much better in the VC-backed world: According to venture fund Rock Health, “femtech” still accounts for just 5% of digital health investment in the US.

“Big companies aren’t interested in women’s health—and smaller companies have a harder time commercializing,” says Stifel analyst Annabelle Samimi.

Evofem, which makes a prescription contraceptive gel called FexC, sought to innovate in a particularly crowded corner of the women’s healthcare market. Millions of women want a better form of contraception, andRo v. Wade The era has made access to birth control more important than ever. And the Affordable Care Act specifically requires insurance companies to fully cover women’s contraception, ostensibly creating a lucrative market for drugmakers to develop new products.

But in reality, insurers are largely refusing to cover these new products, my investigation found — making it financially impossible for small contraceptive manufacturers to survive.

“If the plans followed the rules, we wouldn’t have to worry about the money,” Pelletier says.

The Biden administration has said it is “actively investigating” reports of insurer non-compliance (although insurers generally say they are acting within the law). Any government action would help the 73 million U.S. women of reproductive age, for whom access to reproductive health care is more important than ever. But it may not come fast enough to save Evofem or encourage other companies to innovate in this important, if largely overlooked, market.

I hope you’ll read the full story, which follows Pelletier’s tireless efforts to save her company—while delving into the systemic problems facing millions of American women—EvoFem, all of its competitors, and their potential customers.

Maria Aspan
[email protected]
@mariaspan

Jackson Fordyce curates the deals section of today’s newsletter.

Venture deals

– the kiteA New York-based commerce scaling company, has raised $200 million in funding from black stone And juxtapose.

– VintabioA Philadelphia-based life sciences company to develop cell and gene therapies has raised $64 million in funding led by Decheng Capital.

– CTRL TherapeuticsThe company, a Chicago-based cell therapy platform development company for treating solid tumors, has raised $10 million in seed funding. Common Catalysts Leads and joins the round Intermountain Health, he doesand others.

– RepowerA Birmingham, Ala.-based logistics marketplace for B2B resource sharing, led by $8 million in Series A funding UP.Partners.

– AssisSao Paulo-based virtual assistant for freelancers, has raised $5 million in funding Costanova Ventures Leads and joins the round Maya, Canaan, latitude, in the dance, FJ Labs, 1616, In the buffetand other angels.

– the fireA Miami-based crypto fraud prevention tool, has raised $3.5 million in lead funding the atom.

– Portrait analysisBoston-based generative AI research assistant platform for investment analysts, led by $3 million in pre-seed funding .406 Ventures.

Private ownership

– MSPBSupported by Ascendant partneracquired Palm Beach Digestive Associates, a Delray Beach, Fla.-based gastrointestinal health facility. Financial terms were not disclosed.

– Vander-Bend Manufacturinga Aterian Investment Partners Portfolio companies, acquired Omni Components Corporation, a Hudson, NH-based manufacturer of medical products for surgery. Financial terms were not disclosed.

departure

– Transform Capital Group acquired Bose Professional section of Bose Corporation, a Farmington, Mass.-based audio systems company. Financial terms were not disclosed.

IPOS

– ​TypeTap Insurance groupA Tampa-based homeowner’s insurance provider has withdrawn its plans for an initial public offering

Fund + Fund Fund

– eclipse, a Palo Alto-based venture capital firm, raised $1.23 billion across two funds. The $720 million fund will focus on pre-seed, seed and early stage investments. The $510 million fund will focus on portfolio companies and Series B and C investments.