I was at the AHIP conference in Vegas late last month and caught up with a number of CEOs & execs for some quick bite interviews — around 5 mins getting (I hope) to the gist of what they & their companies are up to. I am dribbling them out–Matthew Holt
Next is Julia Kastner, CPO & Chris Molaro, CEO, Neuroflow, and it includes a great brief product demo from Julia
Telehealth addiction treatment clinic Boulder Care just closed a $36 million Series B. I’ve got Founder & CEO Stephanie Strong here to talk about the virtual care company’s medication-assisted approach to opioid and alcohol use disorder treatment, and its growing-bigger-by-the-day presence in the Medicaid market.
In fact, more than 95% of Boulder Care’s revenue comes in from Managed Medicaid plans, and this focus on making medications like Suboxone accessible to traditionally marginalized patients is not only better for patients (drugs like these can cut all-cause mortality rate by half or more) but also compelling for payers. Stephanie says patients suffering from opioid addiction who go untreated are 550% more expensive to the plan than those who are not, and these types of medications facilitate recovery by making it bearable, blocking withdrawal symptoms.
We get into the details behind Boulder Care’s approach, which includes a number of wrap-around support services, including those provided by the startup’s care delivery team that is set to grow as a result of this Series B funding. And speaking of scaling… Does Stephanie have any concerns about challenges that Boulder Care might face prescribing-and-managing controlled substances as a result of the scrutiny created by Cerebral’s bad behavior? Any additional concerns about changes to the clinic’s telehealth practices when the Covid19 public health emergency comes to an end? And…what about competition in this space?? Particularly as similar-looking Bicycle Health announced its $50 million Series B just days earlier? A great inside look at how virtual care is changing the specialized mental health care space.
Otsuka Pharmaceuticals is expanding its mental health formulary – looking beyond traditional medications to psychedelics, and to the “intersection of technology and psychiatry” with digital therapeutics currently in clinical trials for Major Depressive Disorder. Kabir Nath, Senior Managing Director of Otsuka’s Global Pharmaceutical Business, lets us in on the thinking behind these bold moves, why the pharma co is even innovating to expand the spectrum of treatments available for mental illness in the first place, and how soon these new therapies will reach patients.
“Follow the science” is a key undercurrent of this conversation, particularly as we talk through Otsuka’s investments in psychedelic medicine start-ups Compass Pathways and, more recently, Mindset. Kabir says the body of clinical evidence for these therapies is building and we get his prediction on when they might become more mainstream and readily available.
We also get his take on digital therapeutics (DTx) and the work Otsuka is doing with Click Therapeutics in Major Depressive Disorder. Their clinical trial, done in partnership with Verily, is the first-ever fully remote clinical trial conducted in this space, and the hope is that it not only generates evidence to support the emerging DTx category, but that it also sets a precedent for a new, tech-enabled way to run clinical trials.
This is just the beginning. There’s lots more on the innovations changing pharma and the future of mental health care in this one. Watch now!
Big news coming out of Vida Health today as the chronic condition care startup announces that it will now be able to prescribe meds, med devices, lab tests, and more to its members. This puts Vida Health among the first of the digital health chronic care companies to evolve its offerings beyond apps-and-coaching, leading on this trend to take digital health chronic care into a more full expression of virtual care.
Vida Health’s Chief Medical Officer, Dr. Patrick Carroll, introduces us to the new offering which he tipped us off about when we met him a few months ago, new to his role at Vida and coming in hot from Hims & Hers where he built similar services as he took that company public as CMO.
The new prescribing services will cover both sides of Vida Health’s integrated model: mental health and cardiometabolic health, but in different ways. On the mental health side, Pat says members will be able to receive prescription meds for anxiety and depression ONLY at this time; on the cardiometabolic side, members working with Vida Health will NOT be able to get prescription drugs to help with diabetes or heart health, but would instead be able to get continuous glucose monitors (CGMs) prescribed, specialized diets, and labs, like A1C testing, that require a script.
Do these prescribing services begin to turn Vida Health into a primary care provider? If not, how do these new prescribing and medication management roles integrate with whatever other primary care offering is in place through a member’s plan or employer without adding cost or confusion to the patient experience? We talk through the evolution of both care model and business model as Vida Health adds another layer to its full-stack chronic condition management platform.
A woman was walking in the crosswalk of a busy intersection as the rain started to come down. She looked cold, but more than that, she looked off. She had no shoes on her feet and her countenance was in disarray. It seemed to me that she was in the midst of a mental health crisis.
The woman approached where I was standing and I suggested that she go into the Starbucks on the corner to look for her shoes. At least in there, it would be warm. She didn’t go inside, but instead went to the entrance and sat down on the ground.
Someone must have called 911 because a policeman and an ambulance with an emergency medical technician showed up. The EMT brought a stretcher down from the ambulance as the policeman watched over the situation. The woman got on the stretcher and the EMT placed a blanket over her. As this played out, the policeman stood in the background, allowing the EMT to take primary responsibility for the interaction. Since the woman seemed to pose little risk to herself or others, the response seemed to be the appropriate one.
Those of us in medicine have all seen the famous painting of the Tuesday afternoon lessons at the Salpȇtrière in Paris in the 19th century. In Pierre Aristide André Brouillet’s painting, one can clearly see the great professor, Jean-Martin Charcot, holding forth while the patient, Blanche Whitman, is being supported by a tall young man, Joseph Jules Francois Felix Babinski, the Chef de Clinique (the chief resident) and allegedly the favorite to succeed Charcot. He never did as he was failed repeatedly on the exam necessary to become a faculty member at the university by a jealous, xenophobic, anti-immigrant rival, Charles Bouchard. Babinski was born in France and served in the army twice, but his name was Polish as his parents had emigrated to France to escape bias in Poland (sound familiar?). Ironically almost no one remembers Bouchard (his only contribution being the Charcot-Bouchard aneurysm which may be the cause of some intracerebral hemorrhages), but there is no doctor on earth who does not know Babinski’s name. This is one of many reasons why Babinski is my neurological hero.
With a $75 million investment from Softbank last week, and the addition of former FDA Deputy Commissioner Dr. Anand Shah to its Board of Directors this week, Big Health has sure kicked 2022 off with some noise! But, this is more than just big news for Big Health as CEO Peter Hames is here to tell us. This is a story about the market potential for an all-tech approach to mental health care, AND an important endorsement for digital therapeutics – specifically, those that do NOT require a prescription.
Big Health sits at the intersection of two of the hottest health-tech markets: digital mental health care and digital therapeutics. Its approach, via apps Daylight (for anxiety) and Sleepio (for insomnia), has been flagged as unique because 1) unlike other leading digital mental health companies like Headspace Health or Lyra Health, Big Health’s approach to care is tech-driven and does not depend on coach or clinician intervention, and 2) unlike its digital therapeutics rivals, Pear Therapeutics or Click Therapeutics, Big Health’s business model isn’t relying on prescriptions to get paid.
Big Health is, in other words, proving the market potential for a different “breed” of tech-first, PBM-backed digital therapeutics, and I ask Peter about it head-on as we discuss Softbank’s investment. The mega-fund has placed bets on all sides now, having invested in Cerebral, which delivers clinician-first mental health care and prescription medication, and prescription DTx company Pear, which went public in December 2021. So, what should the market make of the fact that Softbank sees room for Big Health alongside Cerebral and Pear? How have high-profile deals with CVS Health and the NHS in Scotland proven out the model? And, what does the addition of Anand Shah (and his insider perspective on the FDA’s sentiment toward digital therapeutics) indicate about what’s ahead when it comes to the regulatory environment for DTx in the future? So many market dynamics at play, so much to talk about!
In November 2021, 15 prominent organizations including NAMI (the National Alliance on Mental Illness) and Well Being Trust joined together to reimagine what a crisis response system might look like. Their Consensus Approach included the response to mental health crises, cases of suicidal behavior, and instances of substance use disorder. They argued that “Without a systems approach to transformation, simply implementing a new number to call will have little impact on those who are in need.”
The Consensus Approach detailed seven critical pillars upon which a new crisis response system could be based, including Equity and Inclusion, Integration and Partnership, and Standards for Care. Pillar #4 stated that “Law enforcement should take a secondary role in crisis response.” This, they said, would be “a paradigm shift” that recognizes mental health conditions as “matters of health care, not criminal justice.”
Digital mental health startups are leaning into the fact that mental health care is not “one-size-fits all” and, as a result, we’re seeing new offerings hit the market that seek to combine typical therapies and their human-plus-machine delivery in novel ways in order to better meet different patient needs. In this interview, we hear about Resony, a digital therapeutic that’s tackling anxiety and stress through a completely autonomous, AI-driven program that brings together resonance breathing and physical relaxation exercises with cognitive behavioral therapy. In other words… working on the physical side of that mind-body connection for the overall benefit of mental well-being.
Resony is just the first DTx coming out of Rcube Health, one of four early-stage startups that have gained the backing of Bayer G4A as part of their Digital Health Partnerships Program Growth Track. CEO and co-founder Ravi Janapureddy introduces us to the business that he’s building on the thesis that true scalability for digital therapeutics in mental health care relies on full automation – no clinical intervention. In a crowded space, how will Resony stand-out as a stand-alone business, instead of a ‘feature’ for a larger, full-service virtual-first mental health care provider? Is this where Bayer might see the opportunity for an “around the pill” or “alongside the pill” approach? Another digital mental health use case to explore!
Miles Hall, a 23-year-old Black man experiencing a psychotic episode, was shot and killed by police after 911 received calls of a disturbance in his Walnut Creek, California neighborhood. His mother Taun Hall had taken steps to warn the local police that her son had been diagnosed with schizoaffective disorder and that he might be prone to mental health crises. She believed she had done enough to ensure that, in the event of a crisis, her son would be treated with care. But when the crisis came, authorities viewed Miles’ behavior through the lens of public safety, not through the lens of mental health, and it cost him his life.