💊The epidemic that turns babies into addicts.
Up to 75% of infants born to women on opioids require treatment for withdrawal symptoms.
Hello and welcome to Careviser by Marie Loubiere, the weekly newsletter that cuts through the healthcare noise with a single focus: productization of the latest research and tech breakthroughs.
Covid-19 is the epidemic everyone is focused on these days. This week, I cover an epidemic that is deadly too. The opioid crisis. It kills 50,000 Americans every single year. And there’s no vaccine. 💉
Efficacy of motivational-interviewing and guided opioid tapering support for patients undergoing orthopedic surgery (MI-Opioid Taper): A prospective, assessor-blind, randomized controlled pilot trial by Jennifer M. Hah, Jodie A. Trafton, Balasubramanian Narasimhan, Partha Krishnamurthy, Heather Hilmoe Yasamin Sharifzadeh et al. studied how guided opioid tapering support after surgery can help more patients reduce opioid use.
🗝️ Why it matters: Over a hundred and thirty people die every day from an opioid overdose in the US. That’s like a small plane crashing every single day.
It is estimated that the "economic burden" of prescription opioid misuse is $79bn a year, including the costs of healthcare, lost productivity, addiction treatment, and criminal justice involvement.
🔎 Findings: Patients enrolled to receive guided opioid tapering support for a year after surgery through phone calls had a 62% increase in the rate of return to their previous opioid use. Supporting patients to reduce their opioid consumption works.
✅ Limits: The study was done only on 104 patients going through hip or knee arthroplasty at a single U.S. academic medical center. It could be beneficial to enroll a large group of patients to back the findings further.
🕴️ Potential applications: The opioid crisis is a top priority for health authorities in the US. They are ready to deploy millions in funding on evidence-based solutions. This opens the doors for multiple opportunities:
Remote motivational sessions with a trained nurse, social worker or therapist to help patients at risk to develop an addiction (e.g., after surgery, after they have been diagnosed for chronic pain).
Evidence-based therapy programs to help opioid users overcome their addiction as highlighted in Mind-Body Therapies for Opioid-Treated Pain.
Pain medication that is less addictive.
Training programs and risk stratification algorithms for primary care physicians to help them better detect and prevent addiction.
Better management of opioid prescriptions to avoid theft and overuse.
I cover a few of these applications in the start-ups of the week.
Let’s start with my favorite of the week! ♥️ Spark Biomedical is a medical device company that aims to cure opioid withdrawal symptoms through electrical stimulation.
📊 Progress: Launched in 2018, their 510K just got cleared by the FDA so they can now market their device in the US. Apart from grants, there is no public information about external sources of funding for the business.
🦻 Product: The patient has to wear a disposable pair of earpieces all day long. The earpieces send electrical stimulation through the skin that lead the brain to release endorphins and alleviate opioid withdrawal symptoms.
The FDA also granted their device for babies suffering from Neonatal Opioid Withdrawal Syndrome a Breakthrough Device Designation at the end of 2020. It means that the FDA will help them get access to the market faster. This is a super impressive set of achievements in a few years.
🚀 Next step: Go-to-market with physicians. Their device needs to be prescribed by a doctor who will then customize its level of intensity/ usage based on the patient's medical needs. They also need to work with payers to get it reimbursed.
They need a very solid sales team to turn an amazing piece of hardware into a treatment that can be implemented into existing care and reimbursement pathways.
Bicycle Health is the Hims for opioid addiction treatment. Founded in 2017, they prescribe medication (suboxone) to overcome opioid dependency. It is now all done remotely.
⌛ Why now: Addicts are often stigmatized when they visit regular doctors. Remote consultations are more private and comfortable.
💰 Payment model: In California, they accept Medicare and a few insurers. In other states (they cover about half of the US states), it is completely self-payment at the moment which is a huge barrier to access (but cheaper than buying counterfeited suboxone from drug dealers). The monthly fee for the service (excluding medication) is US$199, which isn’t cheap.
👩🏼💻 Team: the founder is a repeat entrepreneur whose last company got acquired by Linkedin (Jeff Weiner, LinkedIn former CEO, is an angel investor). Interestingly enough, I could not identify anyone with a sales, growth or marketing title in their 35-people-team so they haven’t ramped up 1. Patient acquisition 2. Partnerships with payers.
📈 Traction: Bicycle Health started as a clinic in California. They only went online during the covid-19 pandemic as remote consultations for opioid addiction became legal. This created enormous opportunities to tap into new communities and accelerated the traction of the company. About 50% of their new clients had never seeked treatment for their addiction.They have raised over US$5.5mn so far.
👩🏾🤝👩🏼 Similar players in other states (no player is yet present in all US states): Ophelia raised a seed round of $2.7 million from General Catalyst, Refactor Capital and Y Combinator last year. Priced at a similar price point, they are only available in Pennsylvania with plans to expand in upcoming months. Similarly I couldn’t identify anyone in their team focused on sales, marketing or growth. Boulder shows that there is potential in the industry as they raised a US$10.5mn series A with Tusk Ventures and Greycroft Partners...and they just hired a director of growth marketing!
One of the ways to solve the opioid crisis is by developing non-addictive pain medication. This is what California biotech Neumentum aims to achieve.
Founded in 2017, they have raised over US$11mn.
They have a pipeline of two drugs that are in phase II and III. One of them, NTM-006, is licensed from Johnson & Johnson.
They have a small but experienced team.
As usual with pharma, only time will tell if they make it through all the phases.
That’s a wrap for today! Don’t hesitate to reply to this email with comments, I read and answer all emails :)