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Tag: behavior change

Inside 1-Year-Old Calibrate’s $100M Raise for ‘Rx + Behavior Change’ Weight Loss

By JESSICA DaMASSA, WTF HEALTH

Just ONE-year in market, and Calibrate has already closed a $100M Series B co-led by Founders Fund and Tiger Global, with participation from Optum Ventures, Forerunner Ventures, Threshold Ventures, and Redesign Health. Why is this virtual care startup getting so much attention (and funding) from so many notable health tech investors? Founder & CEO Isabelle Kenyon is here to introduce us to the telehealth-plus-prescription-drugs business she’s building to help people lose weight.

This is NOT a Noom. Calibrate’s business model is built around a class of $700-$1,300-per month, prescription weight loss drugs called GLP-1s, which it helps its members sort through for both fit AND health insurance coverage (Isabelle says 90% of Calibrate members get the drugs covered by their health plan.) Once the drug is prescribed, the Calibrate member is wrapped in a telehealth-driven, lifestyle intervention program that addresses sleep, eating, exercise, and emotional health to help support the reset of their metabolism. As a result, Calibrate members are losing an average of 14% of their body weight, a significantly better, more sustainable outcome than achieved in clinical research when the drugs were prescribed without support.

There are lots of compelling aspects to the Calibrate story here, and we get through all of them: the 175M-person total addressable market of Americans diagnosed with obesity… the recent FDA-approval of Novo Nordisk’s new GLP-1 drug called Wegovy… and how Calibrate will use its fresh funding to build-out an Enterprise program aimed at meeting the shifting thinking employers, Medicare Advantage plans, and other health insurers have about obesity treatment as “preventative care” against more costly chronic diseases.

What else could this “behavior change + drug” framework – and its unique de-coupled payment model – be applied to? Diabetes, cholesterol, and hypertension sound like they’re all on the table, but how defensible is this? What stops a pharma company from doing this themselves? Isn’t this digital therapeutics?? A VERY interesting discussion about the often-taboo subject of weight loss, pharma, and the disruption of the healthcare delivery system behind both.

Interview: Steve Curd, CEO Wanda

Another interview from the HIMSS conference earlier this month. The idea behind these interviews is that they give you a quick overview of the companies, and a sense of where the system as a whole is going.

As opposed to interviews with Philips & Xerox, this is one with a real start up called Wanda. CEO Steve Curd was early on at Healtheon (later WebMD) and then CEO of a startup called CareinSync which sold to Hearst. Now Wanda is a brand new well-funded startup (from a UK based-fund called Net Scientific) focused on patient engagement and behavior change using an interesting mix of psychology and analytics (unlike Monty Python’s suggested technique of sarcasm and extreme violence!).

The Mentalists

Obama’s most significant healthcare-related accomplishment this year may well have been his campaign’s demonstration of the effective use of analytics and behavioral insight – strategies that also offer exceptional promise for the delivery of care and the maintenance of health.

For starters, of course, there’s the widely-reported “big data” success of the Obama campaign.  In unprecedented fashioned, they collected, mined, analyzed, and actioned information, microtargeting voters in a remarkably individualized fashion.

Imagine if healthcare interventions could be personalized as effectively (or pursued as passionately).

Another example:  according to the NYT, the Obama campaign hired a “dream team” of behavioral psychologists to burnish their message and bring out the vote, using a range of techniques the field has developed over the years.

According to the article, the behavioral experts “said they knew of no such informal advisory committee on the Republican side.”

This idea of focusing intensively on behavior change is without question an idea whose time has come.

Earlier this year, for instance, a colleague (with similar training in medicine, molecular biology, and business) and I were surveying the biopharma landscape, and were struck by the extent to which classic biology hasn’t (yet) delivered the cures for which we had hoped; physiology turns out to be extremely complicated, and people, and communities, even more so.

We were also struck by the remarkably low adherence rates for many drugs, abysmal whether you look at this from the perspective of clinical care or commercial opportunity (imagine if Toyota lost half their cars on the way to the dealership).
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Gamification

Recently, I’ve met with several internet startups, web thought leaders, and venture capitalists.

There’s one word that’s come up in every conversation and it’s not Plastics.  It’s Gamification.

Gamification, described by Wikipedia is applying gaming principles to non-gaming applications and processes,

“in order to encourage people to adopt them, or to influence how they are used. Gamification works by making technology more engaging, by encouraging users to engage in desired behaviors, by showing a path to mastery and autonomy, by helping to solve problems and not being a distraction, and by taking advantage of humans’ psychological predisposition to engage in gaming.”

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App-Happy Health Care Full of Optimism, Money


There is a corner of the health care industry where rancor is rare, the chance to banish illness beckons just a few mouse clicks away and talk revolves around venture deals, not voluminous budget deficits.

Welcome to the realm of Internet-enabled health apps. Politicians and profit-seeking entrepreneurs alike enthuse about the benefits of “liberating data” – the catch-phrase of U.S. Chief Technology Officer Todd Park – to enable it to move from government databases to consumer-friendly uses. The potential for better information to promote better care is clear. The question that remains unanswered, however, is what role these consumer applications can play in prompting fundamental health system change.

Michael W. Painter, a physician, attorney and senior program officer at the Robert Wood Johnson Foundation, is optimistic. “We think that by harnessing this data and getting it into the hands of developers, entrepreneurs, established businesses, consumers and academia, we will unleash tremendous creativity,” Painter said. “The result will be improved and more cost efficient care, more engaged patients and discoveries that can help drive the next generation of care.”

The foundation is backing up that belief with an open checkbook. RWJF recently awarded $100,000 to Symcat, a multi-functional symptom checker for web and mobile platforms. Developed by two Johns Hopkins University medical students, the app determines a possible diagnosis far more precisely than is possible by just typing in symptoms as a list of words to be searched by “Dr. Google.” Symcat also links to quality information on different providers and can even direct users to nearby emergency care and provide an estimate of the cost.

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Digital Diet

It’s been said that losing weight is much harder than kicking cigarettes or alcohol. After all, because one doesn’t need to smoke or drink, the offending substances can simply be kept out of sight (if not out of mind). Dieting, on the other hands, involves changing the way a person does something we all must do everyday.

It’s no surprise, then, that reports of problematic doctor interactions with social media are popping up with metronomic regularity. When it comes to the smorgasbord of information coursing through those Internet tubes, increasingly, we all have to eat. And that makes drawing boundaries a challenge.

While most early reports on the perils of social media concerned inappropriate postings by physicians, a new hazard has emerged recently: digital distraction. On WebM&M, the AHRQ-sponsored online patient safety journal that I edit, we recently presented a case in which a resident was asked by her attending to discontinue a patient’s Coumadin. As she turned to her smart phone to enter the order, she was pinged with an invitation to a party. By the time she had RSVPed, she had forgotten about the blood thinner – and neglected to stop it. The patient suffered a near-fatal pericardial hemorrhage.

In a commentary accompanying the case, the impossibly energetic John Halamka, ED doctor and Harvard’s Chief Information Officer, described all of the things that his hospital, Beth Israel Deaconess Medical Center, is considering to address this issue. It’s not easy: whereas the hospital owns the Electronic Health Record and can manage access to it, the vast majority of mobile devices in the hospital today – at BI and everywhere else – are the personal property of the users. So Halamka is testing various policies to place some digital distance between the personal and professional, including blocking personal email and certain social networking sites while on duty. He’s even investigating the possibility of issuing docs and nurses hospital-owned mobile devices at the start of shifts, collecting them at the end.

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