A wind of change is blowing through the healthcare sector. Well, only a breeze perhaps, but it does have the potential to develop into a ferocious gale. That, at least, is if Vijay Pande of the Andreessen Horowitz investment company is to be believed. The company invests in start-ups that offer treatments and treatment methods that are set to significantly change current illness-driven healthcare. And Andreessen Horowitz is not the only one. More and more start-ups that focus on Lifestyle as a Medicine are attracting large investments.
Pande very much believes in the emergence of ‘digital therapeutics’ and ‘prescribed nutrition’. Digital therapeutics – remember that name – sounds better than the Dutch equivalents (‘digital treatment methods’ or ‘prescribed nutrients’). After pills based on simple molecules and more complex medicines based on protein, digital therapeutics is regarded as a next step in the development of medication. Digital therapeutics are new treatment methods with digital tools that influence our behaviour, combined with new ways in which we treat illnesses with lifestyle and nutrition.
These new treatment methods are highly suitable for people with chronic metabolic disorders. For people in this category, there are major gains to be made by treating them through what has made them ill - lifestyle. Those with chronic conditions, like type 2 diabetes, are currently treated primarily with medication that fights their symptoms, without actually curing them. However, they would benefit much more from changes to their behaviour, such as a healthy dietary and exercise routine supported by digital resources. An intervention of that kind can reverse type 2 diabetes and probably even cure it.
“A wind of change is blowing through the healthcare sector, with new methods where we treat illnesses with lifestyle and nutrition”
Pharmacy without medicines
For an example, let us look at the United States. I read an interesting article about the Fresh Food Pharmacy programme, which is being offered by healthcare provider, Geisinger. The programme is a new type of pharmacy. It does not offer medicines: the only items on its shelves are healthy and fresh foodstuffs. People with type 2 diabetes who are taking part in the programme, get products at the pharmacy for preparing healthy meals and get coaching in how to do so. The participants are mostly people on low incomes.
“In America, a business model for Lifestyle as a Medicine really does seem to be possible”
It pays to invest
The Fresh Food Pharmacy costs Geisinger around 1,000 dollars per participant per year. The company regards this as an investment, because it produces a better return. The return is measured in terms of an improvement to the biomarker HbA1c. HbA1c measures the fluctuations in the blood sugar levels in the last three months. Geisinger has calculated that a one percent decrease in HbA1c in someone with type 2 diabetes will save 8,000 dollars in the future. And as well as preventing serious consequences that result from type 2 diabetes, the Fresh Food Pharmacy can also prevent other illnesses.
Also in America is another start-up that concentrates on curing illnesses using digital therapeutics. Virta Health is aiming to cure 100 million people of type 2 diabetes, without medication or operations. It is a virtual clinic that first brings people’s sugar levels under control using a special diet before helping them change their behaviour using coaching and eHealth. Virta Health presents itself as a fully viable substitute for the treatment of type 2 diabetes using medication. It should be noted that the company has secured 37 million dollars of start-up capital.
“For people with chronic metabolic illnesses, there are major gains to be made by treating them through what has made them ill - lifestyle”
From a breeze to a gale
It therefore really does seem that a business model for Lifestyle as a Medicine is possible in America. Now of course I realize that the healthcare situation in America cannot be compared to that in the Netherlands. Nonetheless, it is notable that similar initiatives in the Netherlands are very difficult to get off the ground, especially on a large scale. Many initiatives are small in scale or run aground when project grants are halted. There are no major investments in Dutch start-ups in this area. And that is in spite of the fact that many highly promising innovations are being, and have been, developed in relation to this subject in this country. TNO already possesses some of the pieces of the jigsaw - for example, it is able to sub-categorize type 2 diabetics with the help of a new diagnosis method in order to treat them in a targeted manner, using diet and lifestyle. It is also able to give them digital personalized nutritional advice. Which businesses and investors will join TNO in turning the Dutch Lifestyle as a Medicine breeze into a gale and launch the Dutch Virta Health Fresh Food Pharmacy?