The Signals I’m Watching in Women’s Health as 2026 Approaches
An investor’s view on where distribution power, evidence, and risk are quietly shifting
📌 Special note 1: This newsletter is free. But it takes hours each week to research, write, and produce at this level. Here are 5 ways to support my work: 1. click “❤️” to amplify 2. subscribe 3. share this publication 4. buy me coffee 5. become a partner.
📕Special note 2: The Billion Dollar Blindspot (the book) is almost ready to step into the world. If you want to follow the journey, early excerpts, behind-the-scenes notes, and launch news, you can sign up for early access here.
Connect and collaborate with me here! Email | LinkedIn
This essay reflects a capital allocator’s perspective on how women’s health investing is being re-evaluated as the healthcare market resets into 2026.
Rather than cataloguing trends, it examines how investor conviction is forming in practice through changes in distribution power, evidence standards, procurement dynamics, and risk pricing. Drawing on capital behavior across venture, private equity, and healthcare services, the essay explores four signals shaping allocation decisions:
Private equity portfolios emerging as distribution layers
Diagnostics functioning as gateways rather than standalone businesses
Shortening evidence timelines via hybrid validation models
Supply-chain sovereignty becoming a valuation variable
The goal is not to predict outcomes, but to surface how investors are currently assessing risk, durability, and scale in women’s health as capital re-enters the market after 2025.
New Here?
If you are an investor, operator, or women’s health advocate, start here.
→ Preorder the book: The Billion Dollar Blind Spot
→ Subscribe to the podcast: Blindspot Capital
As 2025 draws to a close, the mood around healthcare feels oddly composed. Markets have stabilized after a period of repricing. Capital is moving again, but with more structure and less urgency. The loud optimism of earlier cycles has faded, replaced by something else: a renewed focus on durability, evidence, and paths to scale that can survive friction.
From the capital side, this is a familiar phase. It’s the point in the cycle where broad narratives lose their usefulness and smaller signals start to matter more. Where how something is bought, validated, and adopted becomes more important than how compelling it sounds.
When I look at women’s health heading into 2026, I’m less interested in predicting outcomes than in watching where constraints are shifting.
Who holds distribution power.
What counts as sufficient proof.
Which risks are starting to show up in diligence that didn’t matter a few years ago.
What follows isn’t a thesis or a forecast. It’s a set of signals I’m paying attention to as an investor. These are my observations drawn from capital behavior, procurement dynamics, and how conviction is actually forming.
Some of these may fade. Others may sharpen. For now, they are simply the patterns that feel most instructive as the year turns.
❤️ Enjoying this? If this post sparked something for you, click the ❤️ at the bottom. It helps more than you know and tells me you're reading.
1. PE portfolios are becoming the distribution layer for innovation
One of the quieter shifts I’ve been watching is where adoption actually happens. For years, healthcare technology scaled through fragmented buyers; hospital by hospital, employer by employer, payer by payer. Distribution was slow, expensive, and founder-led. Scale came late, if at all.
What’s changing is not the technology. It’s the buyer.
Private equity portfolios, particularly in health services, diagnostics, and infrastructure-heavy verticals are increasingly acting as coordinated demand surfaces. Not just as exit pathways, but as active distribution layers.
I see this in how PE funds are staffing. Central AI, data, and operations leaders are no longer symbolic hires. Their mandate is portfolio-wide adoption, not experimentation. For vendors, that creates a very different dynamic: a single investment committee decision can unlock multiple implementations, with much of the procurement friction removed.
You can see the consequences already. Companies that look modest on standalone ARR are outperforming peers because their products are designed to slot into portfolio workflows. Meanwhile, technically superior point solutions struggle when their only path to scale is bottom-up selling into overstretched provider organizations.
Like any concentrated system, PE platforms can either compound resilience or accelerate fragility depending on whether efficiency gains are reinvested into system health or simply extracted.
From a capital perspective, this changes how I read early traction. One PE-backed customer with intent to roll out across a platform often matters more than a dozen isolated logos. It also reframes diligence. I’m less interested in whether a product excites individual users and more interested in whether it fits a portfolio-level thesis.
What remains unresolved is durability. Some of this adoption is still driven by short-term cost pressure. I’m watching closely to see which tools survive leadership changes and which fade once initial integration budgets are spent.
What would change my view is evidence that PE-led adoption consistently stalls at pilot stage, or that portfolio mandates prove harder to enforce in regulated clinical settings than they appear today.
For now, the direction of travel is clear: distribution power in healthcare is consolidating and companies designed for that reality will pull ahead.
2. Diagnostics are becoming the gateway, not the business
Another signal I keep coming back to is how diagnostics are being used as access points and not endpoints. Let me explain.
Historically, diagnostic companies were evaluated on relatively narrow terms: test accuracy, reimbursement coverage, volume growth. The test was the business. That framing is breaking down.
Diagnostics are increasingly being deployed as the first acceptable touchpoint in regulated healthcare environments; a way to establish presence, generate data, and unlock downstream pathways that would otherwise take years to access. In many cases, the diagnostic itself is tolerated earlier than the therapeutic, service, or platform it ultimately enables.
You can see this in buyer behaviour. Diagnostics that fits cleanly into existing workflows, procurement frameworks, or population health mandates often clear hurdles that adjacent interventions cannot. The test opens the door; the economic value accrues later.
From a capital perspective, this changes how I read early traction. I’m wary of treating diagnostic revenue as the business signal because modest test adoption can mask something more important: embedded relationships, longitudinal data capture, or preferential positioning for what comes next whether that’s treatment pathways, services, or integrated platforms. The risk, of course, is misinterpretation. Diagnostics that never progress beyond the gateway can look deceptively stable while value creation stalls.
What I’m watching closely is intent. Not what founders say, but how companies design for adjacency: data rights, workflow integration, regulatory sequencing. The difference shows up early if you know where to look.
What would change my view is evidence that reimbursement tightens meaningfully around diagnostic use or that buyers begin to resist downstream expansion rather than pull it forward.
For now, though, diagnostics feel less like destinations and more like keys and capital that prices them as endpoints risks missing where the value is actually forming.
3. Evidence timelines are shortening but only for hybrid proof models
A third pattern I’m watching closely is how evidence is being generated and, more importantly, how it is being accepted. It is tempting to describe this as speed. Faster trials. Faster validation. Faster paths to market. But that framing misses the shift.
What’s actually changing is the definition of enough.
Across regulators, payers, and strategic buyers, I’m seeing selective tolerance for hybrid proof models; combinations of early clinical data, real-world evidence, and well-designed proxies that establish directional confidence before traditional endpoints are fully realized.
You can see it in how programs are structured. Diagnostics paired with observational data. Therapeutics designed with adaptive trial logic. Platforms that sequence validation so that regulatory learning compounds rather than resets. The goal is no longer to prove everything at once, but to prove the right thing at the right moment.
For capital, this has real implications. Conviction is forming earlier but it is also becoming more fragile. When timelines compress, the penalty for sloppy design increases. Teams that treat hybrid validation as a shortcut often pay for it later, through regulatory pushback or stalled adoption. Teams that treat it as a strategy can unlock capital and partnerships sooner than surface metrics suggest.
I’m paying less attention to headline trial progress and more to architecture: how evidence is staged, what assumptions are being tested first, and whether early signals actually reduce downstream uncertainty or merely defer it.
What would change my view is a visible regulatory retrenchment in the form of a tightening of standards in response to early failures or misuse of proxy data. That risk is real and it’s one reason this window may not stay open indefinitely.
For now, though, the implication is clear. Evidence timelines are compressing not because standards are falling, but because sequencing is improving. Capital that understands the difference is gaining an edge.
4. Sovereignty-aligned supply chains are becoming a valuation variable
The final signal I’m watching sits beneath technology and business models. It shows up later in diligence but it increasingly shapes outcomes.
Healthcare supply chains are becoming geopolitical.
This isn’t new in theory, but it’s new in how directly it’s affecting timelines, costs, and valuation assumptions. What used to be treated as an operational consideration i.e. sourcing, manufacturing location, logistics is now bleeding into regulatory risk, clinical continuity, and even insurability.
The example that made this tangible for me wasn’t a frontier technology, but a foundational one. Heparin, a decades-old anticoagulant used daily in surgery and dialysis has a global supply chain that a 2025 review described as “fragile and complex,” dependent on a narrow set of upstream inputs. The science didn’t change. The risk profile did.
I’m seeing similar dynamics surface quietly across diagnostics reagents, APIs, trial materials, and specialized manufacturing inputs; essential components that rarely appear in pitch decks. In regulated systems, disruption doesn’t need to mean shortages to matter. Timing slippage alone can derail clinical programs, delay approvals, or compress margins in ways models don’t capture.
For a capital perspective, this is starting to show up indirectly. Assets with diversified, jurisdiction-aware supply chains move faster through diligence. They clear regulatory questions with fewer surprises and attract fewer last-minute haircuts in M6A. None of this is dramatic and all of it compounds.
What I’m watching most closely is enforcement not reshoring rhetoric. Whether procurement frameworks, regulators, and strategic buyers actually privilege resilience over cost when trade-offs appear. That tension is still unresolved.
For now, though, sovereignty alignment feels less like a macro overlay and more like a quiet filter. It doesn’t create value on its own, but it increasingly determines which value survives friction.
What I’m not convinced by
There are also a few narratives I hear frequently that I’m watching with more caution.
I’m not convinced that “AI everywhere” is a meaningful differentiator in women’s health. In most cases, the technology is necessary but not sufficient. Distribution, evidence design, and buyer alignment still do the heavy lifting, and AI alone rarely resolves those constraints.
I’m also not convinced that consumer-led digital health is poised for a broad rebound in the near term. Engagement remains episodic, willingness to pay is uneven, and the gap between user enthusiasm and institutional adoption has not closed in a durable way.
I’m skeptical of platforms that rely heavily on government or public-system uptake without a clear path through procurement and political cycles. In Europe especially, timelines and incentives remain misaligned, and optimism often outpaces execution.
I’m not persuaded that female-first branding, on its own, creates defensibility. What seems to matter more is data-first stratification; the ability to segment biology, risk, and response in ways buyers and regulators recognize as actionable.
Finally, I’m cautious about claims that market growth alone will correct historical underinvestment. Capital flows tend to follow structure not justice, and without changes in how products are bought, validated, and scaled, growth narratives can stall.
None of these signals, on their own, determine where women’s health will be in a year’s time. But what they do suggest is a shift in where leverage sits; in who controls adoption, how proof is assembled, and which frictions are starting to matter again after a period of relative abundance.
For investors, that changes less about what to believe and more about what to watch.
I’m conscious that some of these patterns may prove temporary, or reveal unintended consequences as they play out. Others may converge in ways that aren’t yet visible. That uncertainty is just part of the work.
As 2026 approaches, I’m paying less attention to declarations and more to behavior. Where capital shows patience. Where buyers commit beyond pilots. Where evidence compounds rather than resets.
If you’re building, allocating, or operating in this space and seeing similar (or very different) signals, I’m always interested in comparing notes.
To go deeper, pre-order my upcoming book The Billion Dollar Blindspot to learn why women’s health is the future of healthcare investing.
Join Our Network
Are you building or backing credible, under-the-radar solutions in women’s health?
We want to hear from you. Reach out privately or reply to this post. We curate brands and breakthroughs that deserve broader attention in the women’s health ecosystem.
I write weekly at The Billion Dollar Blind Spot about capital, care, and the future of overlooked markets. If you are building, backing, or allocating in this space, I’d love to connect.
Disclaimer & Disclosure
This content is for informational and educational purposes only. It does not constitute financial, investment, legal, or medical advice, or an offer to buy or sell any securities. Opinions expressed are those of the author and may not reflect the views of affiliated organisations. Readers should seek professional advice tailored to their individual circumstances before making investment decisions. Investing involves risk, including potential loss of principal. Past performance does not guarantee future results.
Your assessment is so brilliant- I’m a nurse practitioner and definitely going to be keeping these signals in mind!!