Apps and video games are changing the way we treat diseases. Experts say they’re prime M&A targets for telehealth firms.

Pear Therapeutics  reSET-O digital therapeutics app
A patient uses Pear’s reSET-O app to treat opioid use disorder.

  • Apps and video games that can treat health conditions nabbed $1.2 billion in VC dollars in 2019.
  • Only a few commercial products have been launched so far, and they’re struggling to penetrate the healthcare system.
  • Experts say this field is primed for consolidation and could be a great target for telehealth firms.
  • This article is part of a series called “Future of Healthcare,” which explores how technology is driving innovation in the development of healthcare.

Pear Therapeutics is a leader in its field. But the announcement last month that it would go public in a $1.6 billion deal with a special purpose acquisition company, or SPAC, raised eyebrows.

Pear sells three apps designed to treat opioid abuse, substance abuse, and chronic insomnia. But it’s only expecting to make $4 million in revenue this year.

It’s emblematic of where the young field of digital therapeutics stands today. The technology is theoretically promising, but the business model is completely up in the air. Most health insurers don’t cover these products, nor are many physicians prescribing them.

Digital therapeutics are technologies like cell phone apps or virtual reality games that are designed to treat different diseases. In many cases, they target underserved mental health or neurological conditions like post-traumatic stress disorder and schizophrenia.

The plethora of small, young digital therapeutics companies needs a savvy business partner. Pharmaceutical and telehealth companies each stand out as prime options. But, it’s not clear which will truly engage with this new healthcare technology.

“Digital therapeutics, despite being around for a number of years now, it’s still in an early stage of market development. I think the next few years are going to be about what kinds of businesses are best to shepherd through any special clinical benefits,” Jeff Liesch, a consultant at Blue Matter Consulting, told Insider.

As this gets worked out, the digital therapeutics field is likely to see a wave of M&A.

“Consolidation will come, and we’re seeing it coming,” Liesch said.

Pharma giants like Novartis, Roche, and Sanofi have been exploring prescription apps

Digital therapeutics startups are getting their fair share of the investment dollars flowing into the healthcare industry. The amount of venture capital investment in digital therapeutics grew from $134.3 million in 2015 to $1.2 billion in 2019, according to Pitchbook. Another $709 million was invested in the first nine months of 2020, the most recent data available.

Pharma giants like Novartis, Roche, and Sanofi have expressed an interest in the field. Novartis partnered with Pear to launch a schizophrenia therapy, but dropped that project in 2019. It later acquired a digital therapeutics startup developing a 3-D video game to address lazy eye.

FILE PHOTO: The company's logo is seen at the new cell and gene therapy factory of Swiss drugmaker Novartis in Stein, Switzerland, November 28, 2019. REUTERS/Arnd Wiegmann
Pharma giants like Novartis are eyeing digital therapeutics.

Digital therapeutics, particularly those that are prescribed by a physician instead of released directly to consumers, play to pharma’s regulatory strengths while cutting down on the 10-plus years it can take to develop a chemical drug.

The prescription route is where the money is: the annual US revenue expectations for digital therapeutics range between $100 million and $300 million, according to a Blue Matter report.

Before agreeing to pay for them, insurers want to see long-term data showing how the benefits of these prescription apps or video games last. But, multi-year clinical trials are expensive and there’s a chance that at the end of it all, the technology will be outdated, ZS Associates Principal Pete Masloski said.

Even if the companies can get insurers to pay for their products, there’s still the barrier of getting physicians to prescribe them.

Eddie Martucci, the chief executive of digital therapeutics company Akili Interactive, said that thousands of doctors have reached out since the company got Food and Drug Administration clearance last year for an app to treat attention deficit and hyperactivity disorder. But its commercial sales to date are small.

Akili Interactive
Akili CEO Eddit Martucci, right, talks about Akili’s video game with the company’s director of data science in 2015.

At this point, less than 5% of physicians in the US are exploring and prescribing digital therapeutics, according to Masloski.

The next generation of digital therapeutics startups are building in telehealth options

As a young digital health company, is it even worthwhile to try to educate and convince thousands of physicians to prescribe your app? Masloski estimates that time may be better spent by teaming up with a telehealth company with a specialized focus – be it mental health, chronic diseases, or something else – and a pool of medical specialists at hand.

One telehealth firm, UpScript, has already begun offering consultations for Pear’s prescription digital therapeutic. Meanwhile, the next generation of digital therapeutics companies like Happify Health and Kaia Health are building healthcare support staffs around their products.

Kaia Health
Kaia Health’s app

A wave of M&A is just now hitting the telehealth and digital health space, with big names like Teladoc, Ro, and others acquiring smaller players. The digital therapeutics field may also get swept up in that, Masloski said.

“Digital health companies are looking more broadly at ways to expand their impact across different parts of the patient journey. They’re thinking in a platform way, how can I offer employers, for example, diabetes management, mental health services, all of these things?” he said. “They don’t want to work with 1,000 individual different providers. They want to work with platform companies, simplifying their world.”

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There’s a simple way Congress can make birth control easier to access and improve women’s health

stoppingbirthcontrol
Nearly one in 10 women ages 18-25 say they delayed or were not able to get their birth control due to the COVID-19 pandemic.

  • Because of COVID-19, telehealth has become more commonplace and accessible.
  • Allowing women to get and refill birth control prescriptions via text or phone would increase accessibility.
  • Lawmakers must make their constituents’ continued access to basic birth control through telehealth a key focus.
  • Liz Meyerdirk is the CEO of The Pill Club, a direct-to-consumer birth control provider and wellness brand.
  • This is an opinion column. The thoughts expressed are those of the author.
  • See more stories on Insider’s business page.

There are very few upsides to the pandemic, but the accelerated deployment and adoption of telemedicine is certainly one. Our healthcare system was forced to adapt to lockdowns and social distancing, so the CDC issued emergency waivers for patients to use telehealth services from home, allowing doctors to be paid for virtual visits. Clearly, not all medical care can or should be provided virtually forever, but one category absolutely should: birth control. That’s why we’re calling on Congress to increase access to birth control via telehealth on a permanent basis.

Barriers to birth control access

The number of telehealth claims increased 3,060% nationally from October 2019 to October 2020. The telemedicine solutions worked so well that lawmakers are looking to make some emergency stopgaps permanent, and members of Congress have introduced a slew of bills pertaining to telehealth just this year.

The status quo for millions of American women today requires them to see a doctor in person every year to receive a new prescription for a birth control medication they have been on for years if not decades. Women must make these appointments not because they want to, but because in many places they have to, and in other places, because they don’t realize there is another option. Women who are already navigating multiple jobs or caregiving responsibilities also then have to drive, park, take the bus or subway, and wait in line every month at a pharmacy to get a limited supply of their medication, just 30 days at a time.

The persistent physical and economic barriers that keep women from receiving basic healthcare have only increased over the tumultuous past year. We know now that it is women – particularly black women – who are more likely to have lost their job due to the pandemic, and with it their work-related health insurance and access to affordable healthcare. A survey published last month revealed that nearly one in 10 women ages 18-25 and 7% of women ages 26-35 say they delayed or were not able to get their birth control due to the COVID-19 pandemic.

I recently became the CEO of The Pill Club, a company founded in 2016 to address this challenge and make women’s lives easier by delivering on-demand healthcare for their everyday needs. We currently provide 24/7 telehealth services from medical professionals for hundreds of thousands of women in 46 states. Our premise is that women’s health isn’t niche: it’s half the population.

An anecdote that perfectly encapsulates the absurdity of the constraints we place on women to receive this foundational care came my way recently from a current Pill Club member. She was turned away from her annual OB-GYN visit last year because she brought her toddler with her. Having her 2-year-old present violated office COVID-19 restrictions and she had to skip the appointment and forgo receiving a new prescription for a medication she’d been on for years. No one should have to get childcare or time off to gain access to this kind of healthcare.

Telehealth as a solution

“Telehealth” is sometimes used as a shorthand to mean video visits with physicians, but it also can refer to text and phone consultations. Text and phone have proven themselves to be a lifeline to increase access for seniors on Medicare during the pandemic, and we know that it can help younger women, too. Millions of Americans still don’t have high-speed internet, hi-res video, or unlimited data plans, particularly in rural areas and urban centers. Our company oversees nearly 250,000 patient visits a year, the vast majority of which don’t require video consultation. An example of a commonsense public policy change would be to permanently expand access to contraception care via text and phone consultations.

Making it easy for women to receive birth control consultations virtually and their medication by mail should not be viewed as a luxury, but rather a utilitarian tool that can save women precious time while they find a way to make ends meet, care for their children, and put their family lives back together post-pandemic.

This flexibility is even more important for the roughly 17 million women who receive Medicaid services and are currently within their reproductive years. After all, in 2018 Medicaid paid for 42% of all births in the United States, so it seems self-evident that helping women prevent unwanted pregnancies, which often result in costly care, should be top-of-mind for lawmakers.

As we move into a post-pandemic world, one in which women have borne the disproportionate cost of economic and job dislocation, we urge lawmakers to make their constituents’ access to basic birth control a key focus and permanently less of a hassle.

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Founder of Psious predicts VR will play a major role in addressing the mental health crisis caused by the pandemic

Xavier Palomer_foto_Angela Silva_2 min min
Xavier Palomer

The last year has been busy for Xavier Palomer, the founder of Spanish virtual reality mental health startup Psious. The platform, which is a tool for mental health professionals to place their patients in a variety of different situations to try treatments such as exposure therapy or cognitive restructuring, doubled in the number of patients from 2019 to 2020. In all, 20,000 people have been treated using Psious’s platform.

And while the COVID-19 pandemic has strained many healthcare systems, it has shown the need for Psious’s tech and demonstrated the use case, too. Telehealth – where people are treated remotely from their medical professionals – has long been tomorrow’s technology. The promise has long been acknowledged, but the reality has always been that face-to-face meetings were preferred. The pandemic has challenged that notion.

“The adoption rate and interest from both healthcare professionals and patients is growing,” Palomer said. “If people are suffering, they want to use VR.” The normalization of technology in health treatment has been one beneficiary of the long stretches spent at home. “If you do something for a week, you’ll forget it,” Palomer said. “If you do it for a year or more, you get used to it. We’ve normalized this remote use.”

It’s not before time, either. While the pandemic has helped improve uptake of telehealth solutions, time spent away from loved ones, and away from physicians and psychiatrists is generating an enormous backlog of cases that Psious and Palomer hope to be able to help with.

“We’ve been locked down and isolated, with social distancing and a lot of things that make us anxious,” Palomer said. “We’re way more alone now. I used to go every day to the office; I can’t remember when I was last in the office. I don’t interact with my co-workers. When I interact with someone it’s often through a virtual connection. We don’t just talk anymore.”

Palomer thinks the increase in mental health issues is excacerbated by social distancing restrictions, increasingly negative news coverage, and general economic uncertainty for many people. “It’s like the worst mix ever,” Palomer said. “Being alone so you can’t exchange concerns or share problems. A lot of new stuff like face masks – inputs telling you something is wrong – and then bad news in everything you see or watch. It’s very easy to understand that at some point that will blow our minds.”

A mental health crisis on the horizon

Healthcare experts are already seeing the first wave of mental health issues starting to break on the horizon. “Most of us will be able to deal with it and get through it very easily, but a huge part of us won’t go through it very easily, which leads us to a growth in the number of mental health issues like anxiety and depression,” Palomer said. More than just sheer numbers, Palomer thinks physicians are also likely to see the severity of cases increase when the pandemic begins to subside. People will have lost family members; they’ll have spent a year or more locked indoors; they’ll have spent most of it worrying about what the future holds; and they may not have jobs to return to.

Palomer spoke to the head of psychiatry treatment at one of Spain’s largest hospitals. There, the department chief reported a 60% increase in caseload between January 2020 and January 2021. “For a hospital of that size, having that kind of growth in 12 months is just mindblowing,” Palomer said.

He’s concerned that we’re unsuited for what’s about to happen. “Are the systems ready, meaning healthcare providers, public and private systems? Are we ready to answer this demand?” he asks. “The answer is no. We’ll need to find, in the startup language, scalable solutions, and for me one of the best candidates is technology. Virtual reality has a very good clinical background and good validation. The scalability is there. We believe a solution like ours is needed more than ever before.”

Palomer believes Psious is a complement to, rather than a replacement for, face-to-face mental health treatment. But he thinks it’s better suited than most kinds of treatment, citing the way his back pain – the result of caring for three children and a life spent sitting at a computer – is being treated mostly through phone- and app-based physical therapy.

In 12 months’ time Palomer expects to see an even more meaningful increase in patient numbers being treated using Psious’s virtual reality systems. “We want to keep this pace in 2021,” he said. The mental health of us all may depend on it.

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The FDA has authorized a 3rd coronavirus vaccine

Hello,

Today in healthcare news: Johnson & Johnson’s vaccine gets emergency authorization, a fun but far-from-normal summer, and what the Cigna-MDLive deal means for the future of telehealth


johnson and johnson covid vaccine
Johnson & Johnson’s coronavirus vaccine is delivered as a single shot, while both Pfizer and Moderna’s require two jabs.

The US just authorized a 3rd coronavirus shot, adding a convenient, single-dose option to boost the rollout

Read the full story from Andrew Dunn here>>


summer pandemic in the US 4x3

This summer is going to be fun – but far from normal

Read the full story from Andrew Dunn, Hilary Brueck, Aria Bendix, and Patricia Kelly Yeo here>>


telehealth

$74 billion health insurer Cigna is buying MDLive. Here’s what it means for the future of telehealth companies as they look to survive in a post-pandemic world.

Read the full story from Blake Dodge and Shelby Livingston here>>


More stories we’re reading:


– Lydia

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