First Principles | Seeking help from digital therapeutics

Applications are now being deployed to treat all kinds of addictions, issues such as Attention Deficit Disorders and mental health issues to include support and rehabilitation

As this dispatch is being sent, I am a non-smoker, now trained to describe cigarettes as ‘Urine Sticks’ and someone who feels disgusted by it. The outcome of interacting with an app called QuitSure. The hows and whys are a different narrative altogether. What matters here is that this narrative is part of a larger domain that is ‘Digital Therapeutics’, where applications are being deployed to treat all kinds of addictions, issues such as Attention Deficit Disorders (ADD), and mental health issues to include support and rehabilitation.

When the mental health argument is extrapolated here, it is a matter of time before such entities underwrite the cost of the app for people who agree to use it. (Shutterstock)

The thing about this space is that work had started over a decade ago in altogether ubiquitous ways when medical doctors, researchers, technologists and entrepreneurs started to tinker with a question: How do you push the boundaries of technology to deliver treatments? How can we reimagine medicine and the services we offer?

This would become obvious when in conversation with Kuldeep Datay, a clinical psychologist affiliated with the Institute of Psychological Health (IPH). He suggests that we think of tools that aid people meditate such as ‘Head Space’ and ‘Calm’ as starting points. To the untrained eye, apps such as these are intended to help an average person meditate. But in the developed world, where mental health is acknowledged as a serious problem and covered by insurance companies, companies underwrite the cost of such apps and incentivise creators to build them and give users reasons to use them.

Any cases in point?

Datay personally likes Wysa and the features it offers. This is because he often tells those who seek him to write a journal. Most don’t. However, when he recommends an app, “journaling suddenly becomes exotic.” In the longer run, it helps him understand people better and offer better counselling. But his larger point is that while all of these started as meditation apps on the phone, such apps are evolving as not just bridges between users and practitioners like him, but deploying Artificial Intelligence (AI) to do routine counselling.

While it is unclear what else such entities may eventually do, people such as Ram Chandra who thought up QuitSure are convinced about the future. So, he got into the fray with a tobacco cessation programme. It is well known they are susceptible to more diseases, have higher mortality, and insurance companies don’t like them.

When the mental health argument is extrapolated here, it is a matter of time before such entities underwrite the cost of the app for people who agree to use it. That investor interest in the space is high is clear because other ventures such as Quit Genius have raised almost $80 million in funding. Then there is Pivot which has raised $25 million from funders. On his part, Ram Chandra is a serial entrepreneur who has boot-strapped and ploughed his personal funds into the venture. He says it was a conscious decision so he could stay focused on product development and getting approvals from bodies such as the World Health Organisation (WHO) and the US Federal Drug Administration (FDA).

This is the path that mediation apps had taken as well before they evolved into Health Tech companies. What can a tobacco cessation company possibly morph into? How people such as Ram Chandra deals with that question will be interesting to watch.

The elephant in the room is: Are Digital Therapeutics companies sustainable? While it is true investor interest is high, these are early days, and there is consensus among analysts that chasing end consumers is unsustainable. The only companies in the space that have disclosed their financials until now are both American and loss-making entities. That is why there is an urgency for such companies to go after enterprise consumers or governments, for which getting regulatory approvals is important, expensive and time-consuming. To place that in perspective, getting the research done for a peer-reviewed study can take as long as two years and cost at least $200,000.

But Ram Chandra appears unfazed. “The results will bring people in.” On his part, Datay suggests I stick with what works for me. And that these are places where “people can at least make a beginning”.