Issue 056.
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Digital health research from Brian Dolan.
Welcome to E&O.
Last week I wrote up how Apple’s FDA clearances helped Alivecor go more directly-to-consumer. Next week I am open to ideas — what should E&O dig into? Here’s what’s happening this week:
- Happy to report I’ll be the master of ceremonies for the first day of the American Telemedicine Association’s annual conference (June 22-26), which will be online-only this year. The ATA gave me five (5) free passes for E&O subscribers — $650 apiece usually — so, the first five to reply will each get one (1). (Just give me a day or two to get back to you.)
- CMS continues to confuse me this week as Administrator Seema Verma said: “It seems like it would not be a good thing to force our beneficiaries to go back to in-person visits.” But a day later Verma affirmed: “But while telehealth has proven to be a lifeline, nothing can absolutely replace the gold standard: in-person care.” Clear as mud what happens next.
- Maybe this document from Massachusetts’ state HHS is a more revealing look at what reopening brings for telehealth. Some variation on this sentence is used throughout: “Telehealth must continue to be utilized and prioritized, whenever feasible and appropriate.” Perhaps telehealth is platinum in this state, while in-person remains golden?
- I missed that Baxter acquired a wearable vital signs monitoring company, toSense for an undisclosed amount a few months ago. Expect Baxter to make a few other (small) digital health acquisitions to bolster its remote monitoring capabilities. Check out toSense’s site here.
- Another acquisition in the clinical grade motion-tracking wearable space: Clinical trials tech company ERT bought APDM Wearable Technologies. A PE firm, ArchiMed, just acquired Actigraph two weeks ago (Issue 053).
- Interesting (but oddly-worded) McKinsey survey of 1,000 employers finds behavioral health to be a top concern. The survey’s buckets included obesity, smoking, substance abuse and others, but the top answer was a generic catch-all for “chronic illnesses”. Wish they’d unbundled that one to give a clearer snapshot. Still, worth a skim here.
- The health system formerly known as Partners has moved to scale up its deployment of Welldoc Bluestar following a two-year quality improvement study of the diabetes management program. The system formerly known as Partners will now embed Bluestar into its EHR and “evaluate its effectiveness at scale”, according to Welldoc.
- One more thing: Nature published a nice overview of Verily’s Project Baseline. While it wasn’t revealed in that writeup, reading through it led me down a rabbit hole looking for which sleep sensor Google uses in this massive study. Its original and main sleep sensor partner is one I’d never heard of before: Beurer.
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Newtopia, which powers Haven’s health coaching, went public in Canada
You may have heard of Newtopia. Founded in 2016, the Canadian company focuses on behavior change and disease prevention. It also has had a long-running partnership with Aetna.
A few weeks ago Newtopia went public in its home country, and few people took notice.
In addition to the public listing, one other thing you probably don’t know about Newtopia is that it plays a small part in the (once) hyped JP Morgan-Amazon-Berkshire Hathaway joint venture, Haven.
Newtopia provides health coaching for Haven’s first stab at a new health insurance plan. Newtopia’s customer JP Morgan brought the company into Haven. Here’s an excerpt from Newtopia’s filing, which never explicitly reveals its role in Haven:
“In late December 2019, [Newtopia], in partnership with one of its major customers, began participation in a medical heath-plan trial. The participant registrations through the medical trial to date has more than doubled the [Newtopia]’s participant base.”
A benefits summary document that E&O obtained names Newtopia as the company handling health coaching for the new medical plan trial. Newtopia’s deck for investors also features Haven, but the relationship isn’t explained:
Given Haven CEO Atul Gawande’s recent departure (and subsequent press reports wondering if the JV has a path forward), Haven’s success or failure will have an impact on Newtopia’s prospects.
As the above indicates, Newtopia went public before it posted substantial growth. Prior to 2018, for example, its relationship with Aetna accounted for 89 percent of the company’s total revenue. In the time period since then, Aetna has contributed 36 percent of Newtopia’s revenues.
The above pricing is all in Canadian dollars, but the general approach isn’t too different from how companies like Omada Health have priced their diabetes prevention programs. Newtopia takes pains to differentiate its programs from what it describes as “one-size-fits-all” approaches offered by most CDC certified diabetes prevention programs (DPPs).
Newtopia writes that it:
“…emphasizes that its habit change platform is specifically for prevention of multiple chronic diseases, including but not limited to obesity, diabetes, heart disease, stroke and fatty liver disease. Therefore, rather than focusing solely on weight loss, each personalized program also emphasizes long-term improvements in nutrition, physical activity, resilience to stress, sleep, mental and behavioural health and overall lifestyle management.”
Newtopia also describes itself as a pioneer in “genetic engagement”. It uses genetic testing to establish whether participants have inherited risk factors from what it calls the cravings gene, the body fat gene, and the appetite gene. Newtopia uses the results to spark motivation for behavior change.
These competitive positioning charts are always incredible:
Newtopia says its book of business shows 70 percent of enrollees remain engaged for the first 12 months. That number drops to 50 percent by the end of the second year, and it gets down to 45 percent by the end of the third year.
After posting revenues of $1.1 million (USD) in 2017 and $2.2 million (USD) in 2018, Newtopia expects to generate about $9.5 million (USD) in 2020.
Part of that expected growth will depend on the success of another partnership, however. Newtopia hinted that it will go live with CVS in July 2020:
“In addition, the [Newtopia] is projecting significant participant growth from a large US pharmaceutical retail company that recently acquired one of its major customers. The Company has worked closely with the pharmaceutical company since the beginning of 2020 in preparation for a launch date in July 2020.”
Considering Newtopia only really has one major customer — Aetna — and that company merged with a big retail pharmacy… I don’t think I’m out on a limb speculating that they are talking about CVS in the excerpt above.
As an aside, I’m always puzzled why small companies go public. Especially ones with such big-name partners.
And, finally — none of this is investment advice. When companies go public they have to disclose financials and other interesting things, so I dig in to help us all better understand what’s going on.
BMS France partner, cancer-focused Moovcare, gets reimbursement in France
Bristol Myers Squibb France’s partner, Sivan, which offers the cancer-focused digital therapeutic Moovcare, claims to be the first digital therapeutic to secure reimbursement in France.
I’d heard previously that France already covered two digital health products, so maybe this is actually number three.
Firsts are always nuanced and my French isn’t good enough to confirm the specifics of the claim — guessing it hinges on some very precise definition of digital therapeutic. That said, Moovcare has been something of a French government darling when it comes to health innovations as it has shown up to at least one of the government’s past dog and pony shows.
Moovcare describes itself as a digital therapeutic that uses a simple, weekly questionnaire to detect relapse or complication during follow-up care for lung cancer patients. It’s a Class I medical device in the EU, and its clinical studies have concluded the software improves overall survival by 7.6 months.
APM News broke the story that Sivan has come to an agreement with France’s Economic Committee for Health Products (CEPS) on the reimbursement of its Moovcare Lung. APM says it has confirmation from both Sivan and French authorities.
[As a refresher: In Issue 045 I mentioned two worthwhile overviews of all things France and digital health — this post by Health Advances and this report on from the Dutch government.]
Moovecare’s pipeline reveals plans to move beyond lung cancer to all cancers. Then it aims to expand into identifying at-risk populations and other medical conditions.
Back in the US: SaMD for multiple myeloma
Stateside, BMS appears to be hiring for a longterm contract product manager to help it create a SaMD (software as a medical device) capability for patients in clinical trials for multiple myeloma. The blinded job posting (I’m speculating it is BMS) adds: “candidates with further experience in the Digital Therapeutics space is a bonus.”
Quick links to E&O research reports
The links below aim to make it easier for paying subscribers to find the long-form research reports on the E&O site:
The Hinge Health Report (Subscribers-only Link)
The Digital Health Enrollment Report (Subscribers-only Link)
The Omada Health Report (Subscribers-only Link)
The Google Health Report (Subscribers-only Link)
The Pear Therapeutics Report (Subscribers-only Link)
The AliveCor Report (Subscribers-only Link)
Apple’s Healthcare Work Experience (Subscribers-only Link)
Approximating Livongo’s S-1 (Subscribers-only Link)
That’s a wrap on Issue 056 of E&O.
