Issue 002. Omada User Growth. Apple Work Experience. European DTx.
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Apple’s healthcare work experience
This week E&O wrote a deep dive on the Apple health team’s prior work experience. Apple has recruited talent from health systems, pharma companies, medical device makers, and more than two dozen digital health companies. Paying subscribers can read the full 2,500-word report here. That link won’t work if you aren’t already a paying subscriber and this was forwarded your way, so consider signing up right over here.
This is Issue 002: Here we go.
JNJ-Apple AFib study deal-maker on Apple’s inexperience.
The Yale Digital Medicine Symposium, which took place a few weeks ago, included some great discussions. At one point, Dr. John Whang, J&J/Janssen’s head of integrated evidence in cardiovascular and metabolism, who is credited with brokering the big, multi-year AFib study Apple is doing with J&J, talked about how he got the two behemoths together:
“Really, Apple had their own vision. It was not aligned with ours initially, but [I] sort of brought them to — because they are new to healthcare, they don’t really know the dynamics. You can hire people in, but unless you sort of have the DNA of operating in the healthcare environment, you don’t really know the issues you are going to face in implementation. I had to sort of walk them off their storyline to get us in line together and that was sort of the nut of it. And persistence. Probably more than anything else, there were so many times when this thing was going to go dead. And you just pick it back up and you try again. For innovation that is always a key part.”
Whang’s assertion about Apple not having healthcare in its DNA led to this week’s deep dive about Apple’s healthcare work experience. After analyzing Apple’s nearly 25,000 patents for health-related ones, I dug into the backgrounds of the Apple employees listed on the health patents. Read the report if you haven’t already to learn more about where Apple recruits worked previously and where a few Apple health alums work now.
Germany’s health minister pushes for digitization
I’ve yet to find a good English translation of the news coming out of Germany, but Germany’s Health Minister Jens Spahn floated a draft bill this week that would, among other things, create a validation and reimbursement process for digital therapeutics. Germany-based digital therapeutics company Gaia’s CEO Dr. Mario Weiss cheered the news and summed the relevant portion up as follows: “In principle, the digital therapeutic reimbursement process will be similar to drugs. Evidence will be key. All payers in Germany will be obliged to reimburse after the decision by the BfArM (Federal Institute for Drugs and Medical Devices).”
While Sanofi suggests Brexit slows European DTx: Sanofi-Genzyme’s Chief Medical Officer Dr. Ameet Nathwani added the role of Chief Digital Officer earlier this year. In an interview with Bloomberg, Nathwani discussed Sanofi’s partnership with Happify for digital therapeutics focused on depression and multiple sclerosis. Nathwani said digital therapeutic adoption might move more slowly in Europe partially because of Brexit. The slowdown stems from the European Medicines Agency subsequent move from London to Amsterdam.
(Cigna’s) Express Scripts plans a Happtique
The past decade has seen the launch of many digital health formularies that have, at times, described themselves as an Express Scripts for digital health. Xealth, WebMD, Happtique, and RxUniverse are among those trying or have tried to create a digital health formulary.
This week, Express Scripts announced it would launch its own digital health formulary, complete with a validation process overseen by physicians, pharmacists, and other medical researchers. Express Scripts’ validation process will focus on safety, quality, usability, and affordability. When it launches in 2020, Express Scripts plans to have digital offerings focused on diabetes, cardiovascular, behavioral health and pulmonary conditions.
Cigna has tried this before with its GoYou Cigna Marketplace, which it launched in 2013 in partnership with SocialWellth, the company that bought Happtique’s assets.
Omada Health’s user growth
Omada Health announced that it had crossed 250,000 cumulative participants in its diabetes prevention program (DPP) and other offerings. Here’s a look at the company’s cumulative participant growth over time, starting in September 2015 when the company first reported its numbers and had just 20,000 participants.
Meet the new digital medicine association, DiME
New non-profit association Digital Medicine Society (DiME) launched in Cambridge, Massachusetts this week with funding from Arkitekt Ventures, Digitalis Commons, and TMCity. While no members are listed on the group’s website at launch, it does boast a lengthy list of strategic advisors and scientific advisors, including executives from digital therapeutics companies like Pear Therapeutics and Akili Interactive as well as advisors from pharmaceutical companies like Novartis and Genentech-Roche. DiME also seems to be working in tandem with the Digital Therapeutics Alliance as that group’s leader, Megan Coder, is on DiME’s advisory board too.
Akili suggests not to innovate an outcome
Akili’s CEO Eddie Martucci told the Yale Digital Medicine Symposium: “As a general philosophy, I don’t think we should be trying to bring things into clinical trials, at this stage, that are different or disparate from accepted known clinical endpoints. I think we want to be showing that this actually works… you can only innovate so many things, and I generally don’t recommend innovating an outcome for a pivotal trial. I absolutely recommend using digital to get better and better outcomes measures over time, but those, of course, have to be validated.”
Martucci also summed up pricing models for digital therapeutics: value-based pricing models, “potentially” drug pricing models, DC codes “even though these are pieces of software”, medical benefits and DMEs are “starting to emerge”.
Proteus paid when patients 80 percent adherent
Dr. Scooter Plowman, a senior medical director at Proteus Digital Health sat on the same panel as Martucci at the Yale event a few weeks ago. Plowman provided more detail on Proteus’ value-based contract with Palm Springs-based capitated provider group Desert Oasis Healthcare (DOH).
DOH “has about 80,000 senior lives and the average age with our study with them is 72,” Plowman said. “We have had really rapid enrollment, 150 patients in just the last several weeks. The beauty of it is, they are paying us our fees and for our services only when patients are 80 percent adherent and only then we get a bonus payment when they come under control.”
That’s a wrap on Issue 002: Please hit reply to send feedback my way.